Causes of Death in Patients With Celiac Disease in a Population-Based Swedish Cohort

Peters, Ulrike; Askling, Johan; Gridley, Gloria; Ekbom, Anders; Linet, Martha S.

doi:10.1001/archinte.163.13.1566

Cited by 254 publications

(244 citation statements)

References 70 publications

(113 reference statements)

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“…This low global level of adherence to a GFD in individuals with CD is troubling given the known morbidity and mortality associated with long-term untreated symptomatic CD [7,11,28,29] and the lack of any other effective treatment. There are a variety of reasons why it is difficult to follow a GFD, including the fact that wheat-based food products are a major staple in the North American and European diet, and increasingly complex lifestyles have contributed to a greater reliance on packaged convenience foods and meals eaten away from home.…”

Section: Discussionmentioning

confidence: 99%

Factors that Influence Adherence to a Gluten-Free Diet in Adults with Celiac Disease

et al. 2007

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Objective-The only treatment for celiac disease is lifelong adherence to a gluten-free diet, yet adherence is limited and factors influencing adherence are poorly understood. The purpose of this study was to determine factors influencing gluten-free diet adherence in adults with celiac disease.Methods-A questionnaire was developed and administered to 154 adults with celiac disease who then underwent a standardized gluten-free diet evaluation by an experienced nutritionist. Multivariate analysis was conducted to determine factors associated with adherence level.Results-Thirteen factors hypothesized to contribute to gluten-free diet adherence were found to be significantly associated with improved adherence including: understanding of the gluten-free diet, membership of a celiac disease advocacy group, and perceived ability to maintain adherence despite travel or changes in mood or stress (P < 0.001). Conclusions-This study identified specific factors correlated with gluten-free diet adherence. These results provide a foundation for the design of educational interventions to improve adherence. NIH Public Access

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Section: Discussionmentioning

confidence: 99%

Factors that Influence Adherence to a Gluten-Free Diet in Adults with Celiac Disease

et al. 2007

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“…12 Even more, CD was found to be associated with an 8-fold increased risk of death from liver cirrhosis. 13 Thus, CD needs to be excluded before a diagnosis of cryptogenic cirrhosis is considered. 14 CD should be suspected in those subjects with clinical risk factors for CD, such as a positive family history of gluten-sensitive enteropathy or dermatitis herpetiformis, and those who have the human leukocyte antigen DQ2 (HLA-DQ2) or HLA-DQ8 haplotypes, type 1 diabetes mellitus, premature osteoporosis, or osteomalacia.…”

Section: Liver Involvement In Celiac Diseasementioning

confidence: 99%

The liver in celiac disease

2007

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Celiac disease is a common (1% prevalence) chronic immune-mediated disorder of the small intestine induced by dietary wheat, barley, and rye. Several hepatic disorders have been described in association with celiac disease. Isolated hypertransaminasemia with nonspecific histologic changes in a liver biopsy is the commonest hepatic presentation of celiac disease. A gluten-free diet normalizes liver enzymes and histologic changes in most patients. Moreover, celiac disease can coexist with autoimmune liver disorders such as autoimmune hepatitis, primary biliary cirrhosis, and primary sclerosing cholangitis. Celiac disease has increasingly been reported with a variety of other liver diseases. Thus, the hepatologist needs to consider celiac disease in the differential of abnormal liver blood tests and to be aware of the clinical implications of this frequent disease in patients with liver disorders. The possible mechanisms of liver injury and those common factors that explain the association of celiac disease with liver disorders are discussed. The aims of this article are (1) to review the spectrum and pathogenesis of liver injury related to celiac disease and (2) to provide direction to those caring for patients with chronic liver diseases regarding the detection and effective treatment of celiac disease. (HEPATOLOGY 2007;46:1650-1658

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“…The interval between the diagnosis of CD and death was 4 year. PETERS et al (53) in a Swedish population reported that 828 patients with CD died between 1965-1994: non-Hodgkin lymphoma, cancer of the small intestine, autoimmune diseases as rheumatoid arthritis, diffuse disease of connective tissue, or allergic disorders (such as asthma), inflammatory bowel diseases, diabetes mellitus, disorders of immune deficiency, tuberculosis, pneumonia and nephritis. In summary, elevated mortality risk for all causes of death combined reflected, for the most part, disorders characterized by immune dysfunction.…”

Section: Mortality and Causes Of Deathmentioning

confidence: 99%

Celiac disease in Brazilian patients: associations, complications and causes of death. Forty years of clinical experience

Kotze

2009

Arq. Gastroenterol.

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-Context -Celiac disease is a multisystem auto-immune disorder and may start at any age in genetically predisposed individuals. Objective -To identify associations, complications, and cause of death in Brazilian patients. Methods -One hundred and fifty-seven patients were studied: 23 adolescents and 134 adults, 79.6% females, 20.4% males, 75.8% at the time of diagnosis and 24.2% on a gluten-free diet, follow-up between 1 and 40 years. The diagnosis of celiac disease was based on histologic findings and the presence of serologic auto-antibodies markers for celiac disease. Specific tests were done according to clinical suspicion of associations. Bone mineral density was determined by dual energy x-rays in 53 patients upon diagnosis. The data regarding associations, complications, and causes of death were obtained by interviews and from the patient's charts. -Results -Associations: atopy (22.3%), depression (17.2%), thyroid disorder (15.9%), dermatitis herpetiformis (11.5%), diabetes mellitus types 1 and 2 (4.5%) and tumors (4.5%). Complications -Anemia and osteopenia/osteoporosis in all groups; increased number of spontaneous abortion. Four patients (4.5%) died (one from lymphoma, one with diabetes type 1, one from acute meningitis and one due to suicide). Conclusions -This experience is similar to those described in the world literature. Celiac disease presents the same characteristics independently of the geographic region. We recommend periodic evaluations, from childhood, independent of the duration of the diet. The key is to establish an interval between evaluations. HEADINGS -Celiac disease. Gluten. Lymphoma, non-Hodgkin.

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Causes of Death in Patients With Celiac Disease in a Population-Based Swedish Cohort

Abstract: The elevated mortality risk for all causes of death combined reflected, for the most part, disorders characterized by immune dysfunction.

Cited by 254 publications

References 70 publications

Factors that Influence Adherence to a Gluten-Free Diet in Adults with Celiac Disease

Factors that Influence Adherence to a Gluten-Free Diet in Adults with Celiac Disease

The liver in celiac disease

Celiac disease in Brazilian patients: associations, complications and causes of death. Forty years of clinical experience

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