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Am J Epidemiol. 2018 Jan 1;187(1):120-124. doi: 10.1093/aje/kwx210.

Is Blood Transfusion Linked to Celiac Disease? A Nationwide Cohort Study.

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Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Department of Pediatrics, Örebro University Hospital, Örebro, Sweden.
Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom.
Celiac Disease Center, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, New York.
Division of Gastroenterology and Hepatology, Department of Immunology, Mayo Clinic, Rochester, Minnesota.
Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark.
Department of Hematology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
Hematology center, Karolinska University Hospital, Stockholm, Sweden.


The vast majority of patients with celiac disease (CD) have disease-specific antibodies. If such antibodies-or other blood-borne factors that cause CD-are transmissible, it might be reflected by a higher risk of CD in individuals who receive blood from donors with incipient CD. In a retrospective nationwide cohort study of 1,058,289 individuals in Sweden who received a blood transfusion between 1968 and 2012, we examined the risk of transmission of CD (defined as having villous atrophy on small intestinal biopsy) using Cox regression. We also examined whether there were clusters of CD patients who received blood transfusions from the same donor independent of the known donor CD status. Overall, 9,455 patients who had undergone transfusions (0.9%) received a blood transfusion from a donor who had been diagnosed with CD. Of these, 14 developed CD, which corresponds to a hazard ratio of 1.0 (95% confidence interval: 0.9, 1.2) compared with recipients of transfusions from unaffected donors. There were no cases of CD among persons who received plasma or platelet units from donors with CD. We found no evidence of CD clustering among recipients of blood from individual donors (P for trend = 0.28). Our results suggest that CD is not transmitted through blood transfusions.


antibodies; autoimmunity; blood; celiac; gluten; transfusion; transmission


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