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Open Access Highly Accessed Research article

Can head trauma trigger celiac disease? Nation-wide case–control study

Jonas F Ludvigsson123* and Marios Hadjivassiliou4

Author Affiliations

1 Department of Pediatrics, Örebro University Hospital, Örebro, Sweden

2 Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden

3 Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, USA

4 Department of Neurology, Royal Hallamshire Hospital, Sheffield, UK

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BMC Neurology 2013, 13:105  doi:10.1186/1471-2377-13-105

Published: 9 August 2013



TG6, a brain expressed transglutaminase, is implicated in the neurological manifestations of celiac disease (CD). We hypothesized that earlier brain injury due to head trauma may be more common in patients with CD, potentially through trauma-induced TG6 leading to interaction with TG2.


Through biopsy reports from all 28 pathology departments in Sweden we identified 29,096 individuals with CD (in this study defined as villous atrophy). We then examined the risk of earlier head trauma in CD compared to the risk in 144,522 controls matched for age, sex, county and calendar year. Odds ratios (ORs) were calculated using conditional logistic regression.


981 (3.4%) individuals with CD and 4,449 (3.1%) controls had a record of earlier head trauma. Individuals with head trauma were hence at a 1.10-fold increased risk of future CD (95% CI = 1.02-1.17). ORs were independent of sex or age at CD. The highest risk of future CD was seen during the first year after trauma. There was no association between severity of trauma and risk of developing CD.


This study found a very small excess risk for future CD in individuals with an earlier head trauma.

Autoimmunity; Brain; Coeliac; Inflammation; Trauma