People with celiac disease have an increased risk for developing pneumonia, particularly in their first year after diagnosis.
We know that immune system disorders cause abnormally low or high activity of the immune system. We also know that celiac disease is a serious genetic autoimmune condition. This means that instead of fighting off infections that can cause illness, such as pneumonia, antibodies are attacking the body’s own tissues when the autoimmune disease is left undiagnosed. A recent study found that celiac disease patients who are unvaccinated against pneumococcus are nearly 30 percent more likely to develop community-acquired pneumonia (CAP).
Researchers examined rates of CAP in 9,303 people with celiac disease against 101,755 people without the condition. In the celiac disease group, there was a rate of 3.42 cases per 1,000 people, compared to 3.12 cases per 1,000 people in the control group. The risk of CAP was highest in patients with celiac disease in the first year after diagnosis, but persisted in the long term.
Patients with celiac disease are at a greater risk for developing pneumonia. This might be due to diminished spleen function, which affects the ability to fight the bacteria that causes pneumonia.
Pneumococcal vaccines are typically given to people who are younger than 65 years of age, but individuals can receive this vaccine at a younger age if they are considered at increased risk of CAP. The percentage of patients with celiac disease who receive this vaccine is unknown at this time. Though this study does not prove that pneumococcal vaccination reduces the excess risk of CAP in celiac disease, both patients and providers should be made aware of this option for consideration.
Dr. Benjamin Lebwohl, MD, MS, with The Celiac Disease Center at Columbia University adds, “It is reassuring that the risk of pneumonia decreases over time after the diagnosis of celiac disease, which may be a reflection of the beneficial effect of the gluten-free diet. But the risk does not disappear entirely, so vaccination should be strongly considered: certainly for those older than 65, perhaps among younger patients too.”