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

BMC Gastroenterology

Research Article

Giacomo Caio¹  Umberto Volta¹  Alessandra Marchese²  Gino Roberto Corazza²  Annalisa Schiepatti²  Federico Biagi²  Rachele Ciccocioppo²  Paolo Gobbi²  Francesca Ferretti²  Marco Astegiano³  Alida Andrealli³  Antonio Gasbarrini⁴  Anna Chiara Piscaglia⁴  Matteo Neri⁵  Carolina Ciacci⁶  Fabiana Zingone⁶  Anna D’Odorico⁷  Sergio Segato⁸  Italo De Vitis⁹  Giuseppe Ambrosiano^1,10  Pasquale Mansueto^1,10  Antonio Carroccio^1,11  Alberto Meggio^1,12  Giovanni de Pretis^1,12 

[1] 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 Gastro-Hepatology, AOU San Giovanni Battista Molinette, University of Turin, Turin, Italy;Department of Internal Medicine, Catholic University of Sacred Heart, Gemelli University Hospital, Rome, Italy;Department of Internal Medicine, University “G D'Annunzio” of Chieti, Turin, Italy;Department of Medicine and Surgery, Gastrointestinal Immune Diseases Centre, University of Salerno, Salerno, Italy;Department of Surgical and Gastroenterological Sciences, University of Padua, Padua, Italy;Gastroenterology and Endoscopy Unit, Ospedale di Circolo di Varese, Fondazione Macchi, Turin, Italy;Internal Medicine and Gastroenterology Unit, UCSC-CIC, Rome, Italy;Internal Medicine, University of Palermo, Palermo, Italy;Ospedali Civili Riuniti di Sciacca, University of Palermo, Palermo, Italy;UO Multizonale di Gastroenterologia ed Endoscopia APSS Trento, Rome, Italy;

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

DOI  :  10.1186/1471-230X-14-139

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

来源: Springer

【 摘 要 】

BackgroundCoeliac 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.MethodsClinical 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.Results87 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.ConclusionsComplicated 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】

CC BY   
© Biagi et al.; licensee BioMed Central Ltd. 2014