Federico Biagi1, Annalisa Schiepatti2, Gregorio Maiorano2, Giacomo Fraternale2, Simona Agazzi2, Fabiana Zingone3, Carolina Ciacci3, Umberto Volta4, Giacomo Caio4, Raffaella Tortora5, Catherine Klersy6, Gino R Corazza2. 1. Coeliac Centre/First Dept. of Internal Medicine, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Italy. Electronic address: f.biagi@smatteo.pv.it. 2. Coeliac Centre/First Dept. of Internal Medicine, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Italy. 3. Celiac Center at Gastrointestinal Unit, AOU S. Giovanni di Dio e Ruggi d'Aragona, University of Salerno, Italy. 4. Department of Medical and Surgical Sciences, University of Bologna, Italy. 5. Department of Clinical and Experimental Medicine, Unit of Gastroenterology, University of Naples Federico II, Naples, Italy. 6. Biometry and Clinical Epidemiology, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Italy.
Abstract
BACKGROUND: Coeliac disease is characterised by an increased mortality mostly due to its complications. AIMS: To study the risk of developing complications according to clinical presentation and age at diagnosis, a combined retrospective-prospective longitudinal study was performed in three Italian centres. METHODS: Incidence of complications and mortality rates were calculated using type and age at diagnosis of coeliac disease, sex, and centre of diagnosis as predictors. Patients referred after being found to suffer from coeliac disease elsewhere were excluded. RESULTS: Between 01/1999 and 06/2015, 2225 adult coeliac patients were directly diagnosed in our centres. 17 of them developed a complication and 29 died. In patients older than 60 years at diagnosis of coeliac disease, the risk of complication is 18 times higher than in patients diagnosed at 18-40 years and 9 times higher than in patients diagnosed at 40-60 years. Classical presentation increases the risk of complications by 7 times compared to non-classical presentation; in asymptomatic patients the risk of complication is virtually absent. CONCLUSIONS: The risk of developing complications in coeliac patients is linked to age at diagnosis of coeliac disease and type of clinical presentation. Follow-up methods of coeliac patients should be tailored according to these parameters.
BACKGROUND:Coeliac disease is characterised by an increased mortality mostly due to its complications. AIMS: To study the risk of developing complications according to clinical presentation and age at diagnosis, a combined retrospective-prospective longitudinal study was performed in three Italian centres. METHODS: Incidence of complications and mortality rates were calculated using type and age at diagnosis of coeliac disease, sex, and centre of diagnosis as predictors. Patients referred after being found to suffer from coeliac disease elsewhere were excluded. RESULTS: Between 01/1999 and 06/2015, 2225 adult coeliac patients were directly diagnosed in our centres. 17 of them developed a complication and 29 died. In patients older than 60 years at diagnosis of coeliac disease, the risk of complication is 18 times higher than in patients diagnosed at 18-40 years and 9 times higher than in patients diagnosed at 40-60 years. Classical presentation increases the risk of complications by 7 times compared to non-classical presentation; in asymptomatic patients the risk of complication is virtually absent. CONCLUSIONS: The risk of developing complications in coeliac patients is linked to age at diagnosis of coeliac disease and type of clinical presentation. Follow-up methods of coeliac patients should be tailored according to these parameters.
Authors: Elisabeth Megan Rose Baggus; Marios Hadjivassiliou; Simon Cross; Hugo Penny; Heidi Urwin; Sarah Watson; Jeremy Mark Woodward; David S Sanders Journal: Frontline Gastroenterol Date: 2019-08-08
Authors: Annalisa Schiepatti; Anupam Rej; Stiliano Maimaris; Simon S Cross; Petra Porta; Imran Aziz; Tim Key; John Goodwin; Amelie Therrien; Shakira Yoosuf; Daniel A Leffler; Jocelyn A Silvester; Catherine Klersy; Federico Biagi; David S Sanders Journal: Aliment Pharmacol Ther Date: 2021-09-08 Impact factor: 8.171