title: A multicentre case control study on complicated coeliac disease: two different patterns of natural history, two different prognoses.
abstract: 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.
  
  
  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.
  
  
  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.
  
  
  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.
authors.affiliation: Coeliac Centre/First Department of Internal Medicine, Fondazione IRCCS Policlinico San Matteo, University of Pavia, P,le Golgi, 19, I-27100, Pavia, Italy. f.biagi@smatteo.pv.it.
authors.forename: Federico
authors.initials: F
authors.lastname: Biagi
authors.forename: Alessandra
authors.initials: A
authors.lastname: Marchese
authors.forename: Francesca
authors.initials: F
authors.lastname: Ferretti
authors.forename: Rachele
authors.initials: R
authors.lastname: Ciccocioppo
authors.forename: Annalisa
authors.initials: A
authors.lastname: Schiepatti
authors.forename: Umberto
authors.initials: U
authors.lastname: Volta
authors.forename: Giacomo
authors.initials: G
authors.lastname: Caio
authors.forename: Carolina
authors.initials: C
authors.lastname: Ciacci
authors.forename: Fabiana
authors.initials: F
authors.lastname: Zingone
authors.forename: Anna
authors.initials: A
authors.lastname: D'Odorico
authors.forename: Antonio
authors.initials: A
authors.lastname: Carroccio
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Ambrosiano
authors.forename: Pasquale
authors.initials: P
authors.lastname: Mansueto
authors.forename: Antonio
authors.initials: A
authors.lastname: Gasbarrini
authors.forename: Anna Chiara
authors.initials: AC
authors.lastname: Piscaglia
authors.forename: Alida
authors.initials: A
authors.lastname: Andrealli
authors.forename: Marco
authors.initials: M
authors.lastname: Astegiano
authors.forename: Sergio
authors.initials: S
authors.lastname: Segato
authors.forename: Matteo
authors.initials: M
authors.lastname: Neri
authors.forename: Alberto
authors.initials: A
authors.lastname: Meggio
authors.forename: Giovanni
authors.initials: G
authors.lastname: de Pretis
authors.forename: Italo
authors.initials: I
authors.lastname: De Vitis
authors.forename: Paolo
authors.initials: P
authors.lastname: Gobbi
authors.forename: Gino Roberto
authors.initials: GR
authors.lastname: Corazza
mesh_terms: D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000209:etiology / Q000401:mortality; D016022:Case-Control Studies; D002446:Celiac Disease / Q000150:complications / Q000178:diet therapy* / Q000401:mortality; D064068:Collagenous Sprue / Q000209:etiology / Q000401:mortality; D055050:Diet, Gluten-Free; D018450:Disease Progression; D004751:Enteritis / Q000209:etiology / Q000401:mortality; D058527:Enteropathy-Associated T-Cell Lymphoma / Q000209:etiology / Q000401:mortality; D005260:Female; D006801:Humans; D007079:Ileitis / Q000209:etiology / Q000401:mortality; D007414:Intestinal Neoplasms / Q000209:etiology / Q000401:mortality; D007421:Intestine, Small; D007579:Jejunal Diseases / Q000209:etiology / Q000401:mortality; D016393:Lymphoma, B-Cell / Q000209:etiology / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D017211:Treatment Failure
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