@article{ref1,
title="Autoimmune connective tissue disease following carbon monoxide poisoning: a  nationwide population-based cohort study",
journal="Clinical epidemiology",
year="2020",
author="Huang, Chien-Cheng and Ho, Chung-Han and Chen, Yi-Chen and Hsu, Chien-Chin and Lin, Hung-Jung and Wang, Jhi-Joung and Guo, How-Ran",
volume="12",
number="",
pages="1287-1298",
abstract="BACKGROUND: In addition to hypoxia, oxidative stress and inflammation due to carbon  monoxide (CO) poisoning cause adverse health effects. These mechanisms are related  to the occurrence of autoimmune connective tissue disease, but studies on the  association between CO poisoning and autoimmune connective tissue disease are  limited. We conducted a study to evaluate the occurrence of autoimmune connective  tissue disease following CO poisoning. <br><br>METHODS: We identified participants with CO  poisoning diagnosed between 1999 and 2012 from the Nationwide Poisoning Database and  selected participants without CO poisoning from the Taiwan National Health Insurance  Research Database with matching age and index dates at a 1:3 ratio. Sex, underlying  comorbidities, and monthly income were also included in the analyses. We followed up  the participants until 2013 and made comparison of the risk of autoimmune connective  tissue disease between participants with and without CO poisoning. <br><br>RESULTS: The  23,877 participants with CO poisoning had a higher risk for autoimmune connective  tissue disease than the 71,631 participants without CO poisoning (adjusted hazard  ratio [AHR], 3.5; 95% confidence interval [CI], 3.1-3.9) after adjustment for sex,  diabetes, Lyme disease, herpes zoster, infectious mononucleosis, hepatitis, HIV  infection, liver disease, renal disease, non-CO poisoning or drug abuse, malignancy,  hypertension, hyperlipidemia, coronary artery disease, congestive heart failure,  chronic obstructive pulmonary disease, and monthly income. An increased risk was  observed even after 4 years of follow-up (AHR, 3.6; 95% CI, 3.0-4.4). <br><br>CONCLUSION:  The risk of autoimmune connective tissue disease increased following CO poisoning. Close follow-up of the patients with CO poisoning for the development of connective  tissue disease is recommended, and further investigation of the detailed mechanisms  is warranted.<p /> <p>Language: en</p>",
language="en",
issn="1179-1349",
doi="10.2147/CLEP.S266396",
url="http://dx.doi.org/10.2147/CLEP.S266396"
}