title: Low incidence but poor prognosis of complicated coeliac disease: a retrospective multicentre study.
abstract: BACKGROUND
  Coeliac disease is a chronic enteropathy characterized by an increased mortality caused by its complications, mainly refractory coeliac disease, small bowel carcinoma and abdominal lymphoma. Aim of the study was to study the epidemiology of complications in patients with coeliac disease.
  
  
  METHODS
  Retrospective multicenter case-control study based on collection of clinical and laboratory data. The incidence of complicated coeliac disease was studied among coeliac patients directly diagnosed in four Italian centres. Patients referred to these centres after a diagnosis of coeliac disease and/or complicated coeliac disease in other hospitals were therefore excluded.
  
  
  RESULTS
  Between 1/1999 and 10/2011, 1840 adult coeliac patients were followed up for 7364.3 person-years. Fourteen developed complications. Since five patients died, at the end of the observation period (10/2011), the prevalence of complicated coeliac disease was 9/1835 (1/204, 0.49%, 95% CI 0.2-0.9%). The annual incidence of complicated coeliac disease in the study period was 14/7364 (0.2%, 95% CI 0.1-0.31%). Although complications tend to occur soon after the diagnosis of coeliac disease, Kaplan-Meier curve analysis showed that they can actually occur at any time after the diagnosis of coeliac disease.
  
  
  CONCLUSIONS
  Complications of coeliac disease in our cohort were quite rare, though characterised by a very high mortality.
authors.affiliation: Coeliac Centre/First Department of Internal Medicine, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Italy. Electronic address: f.biagi@smatteo.pv.it.
authors.forename: Federico
authors.initials: F
authors.lastname: Biagi
authors.affiliation: Coeliac Centre/First Department of Internal Medicine, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Gobbi
authors.affiliation: Coeliac Centre/First Department of Internal Medicine, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Marchese
authors.affiliation: Coeliac Centre/First Department of Internal Medicine, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Italy.
authors.forename: Edoardo
authors.initials: E
authors.lastname: Borsotti
authors.affiliation: Department of Medicine and Surgery, Gastrointestinal Immune Diseases Centre, University of Salerno, Italy.
authors.forename: Fabiana
authors.initials: F
authors.lastname: Zingone
authors.affiliation: Department of Medicine and Surgery, Gastrointestinal Immune Diseases Centre, University of Salerno, Italy.
authors.forename: Carolina
authors.initials: C
authors.lastname: Ciacci
authors.affiliation: Coeliac Centre/Department of Clinical Medicine, St. Orsola-Malpighi University Hospital, Bologna, Italy.
authors.forename: Umberto
authors.initials: U
authors.lastname: Volta
authors.affiliation: Coeliac Centre/Department of Clinical Medicine, St. Orsola-Malpighi University Hospital, Bologna, Italy.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Caio
authors.affiliation: UO di Medicina, Ospedali Civili Riuniti di Sciacca, University of Palermo, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Carroccio
authors.affiliation: Internal Medicine, University of Palermo, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Ambrosiano
authors.affiliation: Internal Medicine, University of Palermo, Italy.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Mansueto
authors.affiliation: Coeliac Centre/First Department of Internal Medicine, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Italy.
authors.forename: Gino R
authors.initials: GR
authors.lastname: Corazza
mesh_terms: D000008:Abdominal Neoplasms / Q000453:epidemiology*; D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000453:epidemiology*; D016022:Case-Control Studies; D002446:Celiac Disease / Q000453:epidemiology* / Q000401:mortality; D015331:Cohort Studies; D058527:Enteropathy-Associated T-Cell Lymphoma / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D007414:Intestinal Neoplasms / Q000453:epidemiology*; D007421:Intestine, Small; D007558:Italy / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D016393:Lymphoma, B-Cell / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D012189:Retrospective Studies
keywords: Celiac disease/epidemiology; Gluten; Incidence; Prognosis; Risk assessment