Tags

Type your tag names separated by a space and hit enter

Small-intestinal histopathology and mortality risk in celiac disease.
JAMA 2009; 302(11):1171-8JAMA

Abstract

CONTEXT

Studies of mortality in celiac disease have not taken small-intestinal pathology into account.

OBJECTIVE

To examine mortality in celiac disease according to small-intestinal histopathology.

DESIGN, SETTING, AND PATIENTS

Retrospective cohort study. We collected data from duodenal/jejunal biopsies taken between July 1969 and February 2008 on celiac disease (Marsh stage 3: villous atrophy; n = 29,096 individuals) and inflammation (Marsh stage 1-2; n = 13,306) from all 28 pathology departments in Sweden. A third cohort consisted of individuals with latent celiac disease from 8 university hospitals (n = 3719). Latent celiac disease was defined as positive celiac disease serology in individuals with normal mucosa (Marsh stage 0). Through linkage with the Swedish Total Population Register, we estimated the risk of death through August 31, 2008, compared with age- and sex-matched controls from the general population.

MAIN OUTCOME MEASURE

All-cause mortality.

RESULTS

There were 3049 deaths among patients with celiac disease, 2967 with inflammation, and 183 with latent celiac disease. We found an increased hazard ratio (HR) for death in celiac disease (HR, 1.39; 95% confidence interval [CI], 1.33-1.45; median follow-up, 8.8 years), inflammation (HR, 1.72; 95% CI, 1.64-1.79; median follow-up, 7.2 years), and latent celiac disease (HR, 1.35; 95% CI, 1.14-1.58; median follow-up, 6.7 years). The absolute mortality rate was 10.4 (95% CI, 10.0-10.8) per 1000 person-years in celiac disease, 25.9 (95% CI, 25.0-26.8) in inflammation, and 6.7 (95% CI, 5.7-7.6) in latent celiac disease. Excess mortality was 2.9 per 1000 person-years in celiac disease, 10.8 in inflammation, and 1.7 in latent celiac disease. This risk increase was also seen in children. Excluding the first year of follow-up, HRs decreased somewhat.

CONCLUSION

Risk of death among patients with celiac disease, inflammation, or latent celiac disease is modestly increased.

Authors+Show Affiliations

Department of Pediatrics, Orebro University Hospital, Orebro 70185, Sweden. jonasludvigsson@yahoo.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19755695

Citation

Ludvigsson, Jonas F., et al. "Small-intestinal Histopathology and Mortality Risk in Celiac Disease." JAMA, vol. 302, no. 11, 2009, pp. 1171-8.
Ludvigsson JF, Montgomery SM, Ekbom A, et al. Small-intestinal histopathology and mortality risk in celiac disease. JAMA. 2009;302(11):1171-8.
Ludvigsson, J. F., Montgomery, S. M., Ekbom, A., Brandt, L., & Granath, F. (2009). Small-intestinal histopathology and mortality risk in celiac disease. JAMA, 302(11), pp. 1171-8. doi:10.1001/jama.2009.1320.
Ludvigsson JF, et al. Small-intestinal Histopathology and Mortality Risk in Celiac Disease. JAMA. 2009 Sep 16;302(11):1171-8. PubMed PMID: 19755695.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Small-intestinal histopathology and mortality risk in celiac disease. AU - Ludvigsson,Jonas F, AU - Montgomery,Scott M, AU - Ekbom,Anders, AU - Brandt,Lena, AU - Granath,Fredrik, PY - 2009/9/17/entrez PY - 2009/9/17/pubmed PY - 2009/9/23/medline SP - 1171 EP - 8 JF - JAMA JO - JAMA VL - 302 IS - 11 N2 - CONTEXT: Studies of mortality in celiac disease have not taken small-intestinal pathology into account. OBJECTIVE: To examine mortality in celiac disease according to small-intestinal histopathology. DESIGN, SETTING, AND PATIENTS: Retrospective cohort study. We collected data from duodenal/jejunal biopsies taken between July 1969 and February 2008 on celiac disease (Marsh stage 3: villous atrophy; n = 29,096 individuals) and inflammation (Marsh stage 1-2; n = 13,306) from all 28 pathology departments in Sweden. A third cohort consisted of individuals with latent celiac disease from 8 university hospitals (n = 3719). Latent celiac disease was defined as positive celiac disease serology in individuals with normal mucosa (Marsh stage 0). Through linkage with the Swedish Total Population Register, we estimated the risk of death through August 31, 2008, compared with age- and sex-matched controls from the general population. MAIN OUTCOME MEASURE: All-cause mortality. RESULTS: There were 3049 deaths among patients with celiac disease, 2967 with inflammation, and 183 with latent celiac disease. We found an increased hazard ratio (HR) for death in celiac disease (HR, 1.39; 95% confidence interval [CI], 1.33-1.45; median follow-up, 8.8 years), inflammation (HR, 1.72; 95% CI, 1.64-1.79; median follow-up, 7.2 years), and latent celiac disease (HR, 1.35; 95% CI, 1.14-1.58; median follow-up, 6.7 years). The absolute mortality rate was 10.4 (95% CI, 10.0-10.8) per 1000 person-years in celiac disease, 25.9 (95% CI, 25.0-26.8) in inflammation, and 6.7 (95% CI, 5.7-7.6) in latent celiac disease. Excess mortality was 2.9 per 1000 person-years in celiac disease, 10.8 in inflammation, and 1.7 in latent celiac disease. This risk increase was also seen in children. Excluding the first year of follow-up, HRs decreased somewhat. CONCLUSION: Risk of death among patients with celiac disease, inflammation, or latent celiac disease is modestly increased. SN - 1538-3598 UR - https://www.unboundmedicine.com/medline/citation/19755695/Small_intestinal_histopathology_and_mortality_risk_in_celiac_disease_ L2 - https://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2009.1320 DB - PRIME DP - Unbound Medicine ER -