A multicentre case control study on complicated coeliac disease: two different patterns of natural history, two different prognoses

Biagi, Federico; Marchese, A.; Ferretti, Francesca; Ciccocioppo, Rachele; Schiepatti, Annalisa; Volta, Umberto; Caio, Giacomo; Ciacci, Carolina; Zingone, Fabiana; D’Odorico, Anna; Carroccio, Antonio; Ambrosiano, Giuseppe; Mansueto, Pasquale; Gasbarrini, Antonio; Piscaglia, A.C.; Andrealli, Alida; Astegiano, Marco; Segato, Sergio; Neri, Matteo; Meggio, Alberto; Pretis, G. De; Vitis, I. De; Gobbi, Paolo G.

doi:10.1186/1471-230x-14-139

Cited by 30 publications

(32 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Overall, patients with CD do not seem to carry any increased risk of respiratory or cardiovascular diseases and neither of neoplastic pathology, and CD could be eventually considered as a mild disabling disease (10). However, complications, such as severe osteomalacia, might occur in CD, and complicated cases might be associated with high rates of morbidity and mortality (11,12). Therefore, 7% to 30% of the patients with CD develop non-responsive CD regardless of >6 months of a gluten-free diet (1 Not answered, n (%) 1 (0.7) 0 (0.0) 1 (1.0)…”

Section: Discussionmentioning

confidence: 99%

Physicians’ attitude and perception regarding celiac disease: A questionnaire-based study

Jinga

Popp

Balaban

et al. 2018

Turk J Gastroenterol

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Physicians’ attitude and perception regarding celiac disease: A questionnaire-based study

Jinga

Popp

Balaban

et al. 2018

Turk J Gastroenterol

View full text Add to dashboard Cite

show abstract

“…CD is a chronic condition that requires lifelong treatment with a GFD (1)(2)(3)(4) . CD is also characterised by increased mortality, mainly due to its complications, that may even occur many years after the initial diagnosis (5,(7)(8)(9)(10) . Therefore, delivery of the best followup care is an unquestionable necessity for coeliac patients.…”

Section: Discussionmentioning

confidence: 99%

“…Risk of persistent VA is 'very high' (≥46 %) for patients in scenario 1 and 'high' (≥23 %) in scenario 2. They should both be referred for gastroscopy with duodenal biopsy and complete routine laboratory tests to exclude malignant complications of CD (1)(2)(3)(4)(7)(8)(9)(10) . At the same time, strategies to improve GFD adherence are mandatory in these patients.…”

Section: Discussionmentioning

confidence: 99%

“…Currently, a strict gluten-free diet (GFD) is the cornerstone for treatment of CD, resulting in complete clinical and histological recovery in the vast majority of patients (1)(2)(3)(4)(5)(6)(7) . Although rare, complications of CD may occur, leading to long-term reduced quality of life and poor outcomes (7)(8)(9)(10) . The role of mucosal healing on a GFD in predicting poor outcomes in coeliac patients has been the focus of several papers that have provided conflicting results (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22) .…”

mentioning

confidence: 99%

See 1 more Smart Citation

Optimising the follow-up of adult coeliac disease with a clinical-based score to identify patients in need of a histological reassessment: a retrospective single centre study

et al. 2020

Self Cite

View full text Add to dashboard Cite

Follow-up modalities for adult coeliac patients remain controversial. Non-invasive markers to identify coeliac patients on a gluten-free diet (GFD) with persistence of villous atrophy (VA) are still lacking. We aim to develop a score to stratify coeliac patients on a GFD according to their risk of having persistent VA and to tailor follow-up modalities accordingly. The clinical notes of over 700 coeliac patients attending our unit (September 1999–November 2018) were retrospectively examined. A total of 273 patients on a GFD with a histological follow-up performed 12–24 months after diagnosis were selected. We developed a bivariable model based on diet adherence and clinical response evaluated by previously validated methods. A four-level score (0·5, 1·5, 3, 4) was obtained. Patients on a strict GFD and with good clinical conditions (score 4) have a very low risk of persistence of VA (2 (95 % CI 1, 5) %). Conversely, the risk is very high (46 (95 % CI 25, 68) %) in patients with poor adherence to a GFD and unsatisfactory clinical response (score 0·5). A score of 1·5 (poor GFD adherence and persistent well-being) is linked with a high risk (23 (95 % CI 14, 36) %). Risk is intermediate (6 (95 % CI 3, 10) %) in patients scoring 3 (strict GFD and no/partial clinical improvement). Three patients who developed complications belonged to this scenario. Patients at low risk of persistent VA can be followed-up non-invasively, whereas a biopsy should be repeated in those at high/very high risk. Case-by-case evaluation is needed in patients at intermediate risk. Studies on a larger sample size are required to confirm these data.

show abstract

“…Alimentary folate is absorbed by the duodenum and proximal jejunum (Qiu et al , ); consequently, many patients with coeliac disease have folate malabsorption. On the contrary, vitamin B 12 is physiologically absorbed by the terminal ileum, that is less severely affected by the disease; malabsorption of vitamin B 12 , however, may occur in patients with concomitant AIG, which impairs intrinsic factor production, or with ileal involvement, as in coeliac disease complicated by ulcerative jejuno‐ileitis (Biagi et al , ).…”

Section: Pathogenesis Of Anaemia In Immune‐mediated Gi Disordersmentioning

confidence: 99%

Pathogenesis, diagnosis and treatment of anaemia in immune‐mediated gastrointestinal disorders

2018

View full text Add to dashboard Cite

Immune-mediated disorders affecting the gastrointestinal (GI) tract may compromise GI integrity, interfere with the absorption of nutrients and cause bleeding and inflammation. All these features contribute to the pathogenesis of anaemia, the most prevalent extra-intestinal manifestation of immune-mediated GI disorders. Anaemia is most commonly due to iron deficiency and/or inflammation, but vitamin deficiencies and, more infrequently, autoimmune haemolysis or drug-induced myelosuppression can be involved. Here we address several issues related to the differential diagnosis and treatment of anaemia in immune-mediated GI disorders, giving particular relevance to the problem of iron deficiency anaemia associated with inflammation. It is emphasized how, in most cases, anaemias due to iron or vitamin deficiencies are best treated by parenteral administration of the deficient factor(s), and how the available high dose intravenous (IV) iron formulations can reduce ambulatory and social costs of IV iron supplementation, while improving patient's compliance to treatment. Actual and future treatment possibilities for anaemia of inflammation, involving the use of erythropoiesis stimulating agents, biologicals and hepcidin inhibitors are discussed.

show abstract

A multicentre case control study on complicated coeliac disease: two different patterns of natural history, two different prognoses

Cited by 30 publications

References 31 publications

Physicians’ attitude and perception regarding celiac disease: A questionnaire-based study

Physicians’ attitude and perception regarding celiac disease: A questionnaire-based study

Optimising the follow-up of adult coeliac disease with a clinical-based score to identify patients in need of a histological reassessment: a retrospective single centre study

Pathogenesis, diagnosis and treatment of anaemia in immune‐mediated gastrointestinal disorders

Contact Info

Product

Resources

About