Patients with Celiac Disease and Related Conditions at Increased Risk of Death

Patients with celiac disease and celiac disease-related disorders are at a slightly increased risk of death when compared to patients without any problems due to celiac disease or related conditions, according to the results of a new study published in the Journal of the American Medical Association.

Jonas F. Ludvigsson, MD, PhD, Örebro University Hospital, Örebro, Sweden, and colleagues examined histopathology data collected from biopsies, finding 3,049 deaths among patients with celiac disease, 2,967 deaths in patients with inflammation, and 183 deaths in those with latent celiac disease. According to the researchers, an increased risk of death existed for patients in all three groups; patients with inflammation were at a 72% increased risk of death, patients with celiac disease were at a 39% increased risk of death, and patients with latent celiac disease were at a 35% increased risk of death.

During the study, the researchers examined data from duodenal and jejunal biopsies that were 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,” as well as a third group of patients from eight university hospitals who had latent celiac disease (n = 3719). The researchers also used the Swedish Total Population Register to “estimate the risk of death through August 31, 2008 compared with age- and sex-matched controls from the general population.”

According to the researchers, the risk of death was greatest in the first year of follow-up, with celiac disease being associated with a 2.8-fold increased risk of death, inflammation with a 4.7-fold increase, and latent celiac disease with a 1.8-fold increase. Risk of death decreased after the first year of follow-up. Additionally, the researchers noted that the risk of death decreased with age at the time of diagnosis, with patients diagnosed before age 20 at a higher risk of death.

“In conclusion, we found increased hazard ratios (HRs) for death in individuals with biopsy-verified celiac disease, inflammation, and latent celiac disease, although absolute risks were small,” the researchers wrote. “Individuals undergoing small-intestinal biopsy in childhood had increased HRs for death. Cardiovascular disease and malignancy were the main causes of death in celiac disease.”