Coeliac Centre/First Dept. of Internal Medicine, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Italy.
Coeliac Centre/First Dept. of Internal Medicine, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Italy.
Dig Liver Dis. 2018 Jun;50(6):549-552. doi: 10.1016/j.dld.2017.12.001. Epub 2017 Dec 8.
Coeliac disease is characterised by an increased mortality mostly due to its complications.
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.
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.
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.
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.
乳糜泻的特征是死亡率增加，主要是由于其并发症。
为了研究根据临床表现和诊断时的年龄发生并发症的风险，在三个意大利中心进行了一项回顾性前瞻性纵向研究。
使用乳糜泻的类型和诊断时的年龄、性别和诊断中心作为预测因素，计算并发症的发生率和死亡率。排除在其他地方发现患有乳糜泻后转介的患者。
在 1999 年 1 月至 2015 年 6 月期间，我们中心直接诊断出 2225 例成年乳糜泻患者。其中 17 例发生并发症，29 例死亡。在诊断为乳糜泻时年龄超过 60 岁的患者中，发生并发症的风险比诊断为 18-40 岁和 40-60 岁的患者高 18 倍。与非经典表现相比，经典表现使发生并发症的风险增加了 7 倍；无症状患者发生并发症的风险几乎不存在。
乳糜泻患者发生并发症的风险与乳糜泻的诊断年龄和临床表现类型有关。应根据这些参数调整乳糜泻患者的随访方法。
