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Autoimmune comorbidity in achalasia patients
Author(s) -
RomeroHernández Fernanda,
FuruzawaCarballeda Janette,
HernándezMolina Gabriela,
AlejandroMedrano Edgar,
NúñezÁlvarez Carlos A,
HernándezRamírez Diego F,
AzamarLlamas Daniel,
OlivaresMartínez Elizabeth,
Breña Blanca,
Palacios Axel,
Valdovinos Miguel A,
CossAdame Enrique,
RamosÁvalos Bárbara,
TorresLanda Samuel,
HernándezÁvila Axel A,
FloresNájera Athenea,
TorresVillalobos Gonzalo
Publication year - 2018
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.13839
Subject(s) - medicine , achalasia , gerd , gastroenterology , disease , comorbidity , autoimmune disease , autoimmunity , reflux , esophagus
Background and Aim Idiopathic achalasia is a rare esophageal motor disorder. The disease state manifests local and systemic inflammation, and it appears that an autoimmune component and specific autoantibodies participate in the pathogenesis. The study aims to determine the prevalence of autoimmune and chronic inflammatory diseases in patients with achalasia and compare the results with those from patients with gastroesophageal reflux disease (GERD). Methods It was a cross‐sectional and included 114 patients with idiopathic achalasia and 114 age‐matched and sex‐matched control patients with GERD. Data on the presence of autoimmune and inflammatory diseases, the time of presentation, and any family history of autoimmune disease were obtained from the hospital's medical records. Results Seventy three (64%) were female patients (mean age: 42.3 ± 15.5; median disease duration: 12 months). We identified the presence of autoimmune disease in 19 patients with achalasia (16.7%), hypothyroidism was the main diagnosis, and it was present in 52.6% of patients compared with 4.2% in controls. Thirteen of the 19 achalasia patients (68.4%) with autoimmune disease had history of familial autoimmunity. We identified 11 achalasia (9.6%) and 5 GERD patients (4.16%) with an inflammatory condition. Compared with the GERD, the achalasia group was 3.8 times more likely to have an autoimmune disease (95% CI: 1.47–9.83), 3.0 times more likely to have thyroidopathies (95% CI: 1.00–9.03), and 3.02 times more likely to suffer from any chronic inflammatory disease (95% CI: 1.65–6.20). Conclusions The non‐negligible number of patients with autoimmune diseases identified among the patients with idiopathic achalasia supports the hypothesis that achalasia has an autoimmune component.