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Multicenter Study
. 2014 Aug 7:14:139.
doi: 10.1186/1471-230X-14-139.

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

Federico Biagi  1 , Alessandra Marchese, Francesca Ferretti, Rachele Ciccocioppo, Annalisa Schiepatti, Umberto Volta, Giacomo Caio, Carolina Ciacci, Fabiana Zingone, Anna D'Odorico, Antonio Carroccio, Giuseppe Ambrosiano, Pasquale Mansueto, Antonio Gasbarrini, Anna Chiara Piscaglia, Alida Andrealli, Marco Astegiano, Sergio Segato, Matteo Neri, Alberto Meggio, Giovanni de Pretis, Italo De Vitis, Paolo Gobbi, Gino Roberto Corazza
Affiliations
Multicenter Study

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

Federico Biagi et al. BMC Gastroenterol. .

Abstract

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.

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Figures

Figure 1
Figure 1
Kaplan Meier curve showing the cumulative complication-free survival from diagnosis of coeliac disease until diagnosis of complicated coeliac disease in the 87 cases.
Figure 2
Figure 2
Kaplan Meier curve showing the cumulative survival from diagnosis of complicated coeliac disease until time of death in the 87 cases.
Figure 3
Figure 3
Kaplan Meier curve showing the cumulative survival from diagnosis of complicated coeliac disease until time of death in the 87 cases divided according to the type of natural history of disease. Thin line: type B cases, who initially responded to a gluten-free diet; thick line: type A cases, who never responded to a strict gluten-free diet.
See this image and copyright information in PMC

References

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