A multicentre case control study on complicated coeliac disease: two different patterns of natural history, two different prognoses

BMC Gastroenterology

Gino Roberto Corazza³  Paolo Gobbi³  Italo De Vitis⁹  Giovanni de Pretis^1,10  Alberto Meggio^1,10  Matteo Neri⁴  Sergio Segato^1,12  Marco Astegiano⁵  Alida Andrealli⁵  Anna Chiara Piscaglia^1,11  Antonio Gasbarrini^1,11  Pasquale Mansueto⁷  Giuseppe Ambrosiano⁷  Antonio Carroccio⁸  Anna D’Odorico⁶  Fabiana Zingone¹  Carolina Ciacci¹  Giacomo Caio²  Umberto Volta²  Annalisa Schiepatti³  Rachele Ciccocioppo³  Francesca Ferretti³  Alessandra Marchese³  Federico Biagi³ 

[1] Department of Medicine and Surgery, Gastrointestinal Immune Diseases Centre, University of Salerno, Salerno, Italy;Coeliac Centre/Department of Clinical Medicine, St Orsola-Malpighi University Hospital, Bologna, Italy;Coeliac Centre/First Department of Internal Medicine, Fondazione IRCCS Policlinico San Matteo, University of Pavia, P.le Golgi, 19, I-27100, Pavia, Italy;Department of Internal Medicine, University “G D'Annunzio” of Chieti, Turin, Italy;Department of Gastro-Hepatology, AOU San Giovanni Battista Molinette, University of Turin, Turin, Italy;Department of Surgical and Gastroenterological Sciences, University of Padua, Padua, Italy;Internal Medicine, University of Palermo, Palermo, Italy;Ospedali Civili Riuniti di Sciacca, University of Palermo, Palermo, Italy;Internal Medicine and Gastroenterology Unit, UCSC-CIC, Rome, Italy;UO Multizonale di Gastroenterologia ed Endoscopia APSS Trento, Rome, Italy;Department of Internal Medicine, Catholic University of Sacred Heart, Gemelli University Hospital, Rome, Italy;Gastroenterology and Endoscopy Unit, Ospedale di Circolo di Varese, Fondazione Macchi, Turin, Italy

关键词: Gluten-free diet;    Glutens;    Prognosis;    EATL;    Complications;    Celiac disease;   

Others  :  1121856
DOI  :  10.1186/1471-230X-14-139

 received in 2014-01-03, accepted in 2014-07-28,  发布年份 2014

【 摘 要 】

Background

Coeliac disease is a common enteropathy characterized by an increased mortality mainly due to its complications. The natural history of complicated coeliac disease is characterised by two different types of course: patients with a new diagnosis of coeliac disease that do not improve despite a strict gluten-free diet (type A cases) and previously diagnosed coeliac patients that initially improved on a gluten-free diet but then relapsed despite a strict diet (type B cases). Our aim was to study the prognosis and survival of A and B cases.

Methods

Clinical and laboratory data from coeliac patients who later developed complications (A and B cases) and sex- and age-matched coeliac patients who normally responded to a gluten-free diet (controls) were collected among 11 Italian centres.

Results

87 cases and 136 controls were enrolled. Complications tended to occur rapidly after the diagnosis of coeliac disease and cumulative survival dropped in the first months after diagnosis of complicated coeliac disease. Thirty-seven cases died (30/59 in group A, 7/28 in group B). Type B cases presented an increased survival rate compared to A cases.

Conclusions

Complicated coeliac disease is an extremely serious condition with a high mortality and a short survival. Survival depends on the type of natural history.

【 授权许可】

   
2014 Biagi et al.; licensee BioMed Central Ltd.

【 图 表 】

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