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

作者：Biagi Federico^*; Marchese Alessandra; Ferretti Francesca; Ciccocioppo Rachele; Schiepatti Annalisa; Volta Umberto; Caio Giacomo; Ciacci Carolina; Zingone Fabiana; D' Odorico Anna; Carroccio Antonio; Ambrosiano Giuseppe; Mansueto Pasquale; Ga**arrini Antonio; Piscaglia Anna Chiara; Andrealli Alida; Astegiano Marco; Segato Sergio; Neri Matteo; Meggio Alberto; de Pretis Giovanni; De Vitis Italo; Gobbi Paolo; Corazza Gino Roberto

来源：BMC Gastroenterology, 2014, 14(1): 139.

DOI：10.1186/1471-230X-14-139

• Celiac disease
• Complications
• EATL
• Prognosis
• Glutens
• Gluten-free diet

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. %26lt;br%26gt;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. %26lt;br%26gt;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. %26lt;br%26gt;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.

• 出版日期2014-8-7