No association between celiac disease and multiple sclerosis in population-based data Jonas Ludvigsson, Karolinska Institutet 31 May 2011 The authors are to be commended for their interesting study. At the same time I would like to draw their attention to the largest study on celiac disease and mutliple sclerosis to this date: Ludvigsson JF, Olsson T, Ekbom A, Montgomery SM. A population-based study of coeliac disease, neurodegenerative and neuroinflammatory diseases. Aliment Pharmacol Ther 2007;25(11):1317-27. http://www.ncbi.nlm.nih.gov/pubmed/17509100?dopt=Citation In this study we examined the risk of multiple sclerosis (and other neurological disorders) in 14,000 patients with celiac disease in Sweden. Patients with celiac disease were at no increased risk of MS (Hazard ratio, HR=0.9; 95%CI=0.3-2.3). When in a case-control analysis we instead investigated the risk of a future celiac disease diagnosis among individuals who were first diagnosed with MS, the Odds ratio for future CD was 1.8 (95%CI=0.9–3.7). I would be interested to hear from the authors why our study results differ? Yours sincerely, Dr Jonas F Ludvigsson Competing interests None.