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RESEARCH PRODUCT
A multicentre case control study on complicated coeliac disease: two different patterns of natural history, two different prognoses
Sergio SegatoCorazza Gino RobertoCarolina CiacciRachele CiccocioppoAnnalisa SchiepattiAnna D'odoricoAnna Chiara PiscagliaGiovanni De PretisA. MarcheseUmberto VoltaAlida AndrealliPasquale MansuetoMarco AstegianoFrancesca FerrettiItalo De VitisPaolo G. GobbiFederico BiagiMatteo NeriAlberto MeggioGiuseppe AmbrosianoAntonio GasbarriniGiacomo CaioAntonio CarroccioFabiana Zingonesubject
MaleComplicationsSettore MED/09 - Medicina InternaLymphomaSmallGastroenterologyCoeliac diseaseEnteropathy-Associated T-Cell LymphomaIntestine SmallMedicineCeliac diseaseEnteropathyTreatment FailureINTESTINAL T-CELL LYMPHOMAGastroenterologyGLUTEN FREE DIETGeneral Medicinecomplicated coeliac disease; natural history; prognosis;IleitisMiddle AgedPrognosisEnteritisIntestineNatural historyAdult; Aged; Carcinoma; Case-Control Studies; Celiac Disease; Collagenous Sprue; Disease Progression; Enteritis; Enteropathy-Associated T-Cell Lymphoma; Female; Humans; Ileitis; Intestinal Neoplasms; Intestine Small; Jejunal Diseases; Lymphoma B-Cell; Male; Middle Aged; Prognosis; Treatment Failure; Diet Gluten-Freenatural historyGluten-free dietDisease ProgressionEnteropathy-associated T-cell lymphomaFemaleprognosiResearch ArticleCollagenous SprueAdultmedicine.medical_specialtyLymphoma B-CellGlutensSettore MED/12 - GASTROENTEROLOGIAcomplicated coeliac diseasecomplications/drug therapy/mortality Myocytes; celiac diseaseNODiet Gluten-FreeInternal medicineIntestinal NeoplasmsHumanscomplications/drug therapy/mortalitySurvival rateCELIAC DISEASE; Complications; INTESTINAL T-CELL LYMPHOMA; prognosis; GLUTEN FREE DIETAgedcomplications/drug therapy/mortality; Myocytes; celiac diseaseMyocytesbusiness.industryCarcinomaB-CellCase-control studynutritional and metabolic diseasesJejunal DiseasesHepatologymedicine.diseasedigestive system diseasesDietEATLCase-Control StudiesGluten-FreeGluten freebusinessComplicationcoeliac diseasedescription
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.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2014-08-01 |