BACKGROUND AND AIM: Clinically diagnosed coeliac disease patients carry an increased risk of mortality. As coeliac disease is markedly underdiagnosed, we aimed to quantify the risk of mortality in subjects with unrecognized and thus untreated coeliac disease. METHOD: Blood samples from 6,987 Finnish adults were drawn in 1978-80, and sera were tested for immunoglobulin A (IgA)-class tissue transglutaminase antibodies (Eu-tTG) in 2001. Positive sera were further analysed for endomysial (EMA) and tissue transglutaminase antibodies by another test (Celikey tTG). EMA- and Celikey tTG-positive cases were compared to negatives as regards mortality in up to 28 years of surveillance, yielding a total follow-up of 147,646 person years. Dates and causes of death were extracted from the nation-wide database. RESULTS: Altogether 74 (1.1%) of the participants were EMA- and 204 (2.9%) Celikey tTG-positive. The age- and sex-adjusted relative risk of overall mortality was not increased in either EMA (0.78, 95% CI 0.52-1.18) or Celikey tTG (1.19, 95% CI 0.99-1.42) -positive subjects. However, antibody-positive cases evinced a tendency to die from lymphoma, stroke, and diseases of the respiratory system. CONCLUSIONS: The prognosis of unrecognized coeliac disease was good as regards overall mortality, which does not support screening of asymptomatic coeliac disease cases.
BACKGROUND AND AIM: Clinically diagnosed coeliac disease patients carry an increased risk of mortality. As coeliac disease is markedly underdiagnosed, we aimed to quantify the risk of mortality in subjects with unrecognized and thus untreated coeliac disease. METHOD: Blood samples from 6,987 Finnish adults were drawn in 1978-80, and sera were tested for immunoglobulin A (IgA)-class tissue transglutaminase antibodies (Eu-tTG) in 2001. Positive sera were further analysed for endomysial (EMA) and tissue transglutaminase antibodies by another test (Celikey tTG). EMA- and Celikey tTG-positive cases were compared to negatives as regards mortality in up to 28 years of surveillance, yielding a total follow-up of 147,646 person years. Dates and causes of death were extracted from the nation-wide database. RESULTS: Altogether 74 (1.1%) of the participants were EMA- and 204 (2.9%) Celikey tTG-positive. The age- and sex-adjusted relative risk of overall mortality was not increased in either EMA (0.78, 95% CI 0.52-1.18) or Celikey tTG (1.19, 95% CI 0.99-1.42) -positive subjects. However, antibody-positive cases evinced a tendency to die from lymphoma, stroke, and diseases of the respiratory system. CONCLUSIONS: The prognosis of unrecognized coeliac disease was good as regards overall mortality, which does not support screening of asymptomatic coeliac disease cases.
Authors: Jonas F Ludvigsson; Timothy R Card; Katri Kaukinen; Julio Bai; Fabiana Zingone; David S Sanders; Joseph A Murray Journal: United European Gastroenterol J Date: 2015-04 Impact factor: 4.623
Authors: Jonathan D Godfrey; Tricia L Brantner; Waleed Brinjikji; Kevin N Christensen; Deanna L Brogan; Carol T Van Dyke; Brian D Lahr; Joseph J Larson; Alberto Rubio-Tapia; L Joseph Melton; Alan R Zinsmeister; Robert A Kyle; Joseph A Murray Journal: Gastroenterology Date: 2010-06-01 Impact factor: 22.682
Authors: Alberto Rubio-Tapia; Mussarat W Rahim; Jacalyn A See; Brian D Lahr; Tsung-Teh Wu; Joseph A Murray Journal: Am J Gastroenterol Date: 2010-02-09 Impact factor: 10.864
Authors: Jonas F Ludvigsson; Benjamin Lebwohl; Alberto Rubio-Tapia; Joseph A Murray; Peter H R Green; Anders Ekbom Journal: J Gastroenterol Date: 2013-02-27 Impact factor: 7.527