The DOI matches its Crossref record; 1 of the 1 references it cites were found in a registry or an index.
Mucosal Recovery and Mortality in Adults With Celiac Disease After Treatment With a Gluten-Free Diet
Open accessAbstract
OBJECTIVES: Clinical response is typically observed in most adults with celiac disease (CD) after treatment with a gluten-free diet (GFD). The rate of mucosal recovery is less certain. The aims of this study were (1) to estimate the rate of mucosal recovery after GFD in a cohort of adults with CD, and (2) to assess the clinical implications of persistent mucosal damage after GFD. METHODS: The study group included adults with biopsy-proven CD evaluated at the Mayo Clinic who had duodenal biopsies at diagnosis and at least one follow-up intestinal biopsy to assess mucosal recovery after starting a GFD. The primary outcomes of interest were mucosal recovery and all-cause mortality. RESULTS: Of 381 adults with biopsy-proven CD, 241 (73% women) had both a diagnostic and follow-up biopsy available for re-review. Among these 241, the Kaplan-Meier rate of confirmed mucosal recovery at 2 years following diagnosis was 34% (95% confidence interval (CI): 27-40%), and at 5 years was 66% (95% CI: 58-74%). Most patients (82%) had some clinical response to GFD, but it was not a reliable marker of mucosal recovery (P=0.7). Serological response was associated with confirmed mucosal recovery (P=0.01). Poor compliance to GFD (P<0.01), severe CD defined by diarrhea and weight loss (P<0.001), and total villous atrophy at diagnosis (P<0.001) were strongly associated with persistent mucosal damage. There was a trend toward an association between achievement of mucosal recovery and a reduced rate of all-cause mortality (hazard ratio=0.13, 95% CI: 0.02-1.06, P=0.06), adjusted for gender and age. CONCLUSIONS: Mucosal recovery was absent in a substantial portion of adults with CD after treatment with a GFD. There was a borderline significant association between confirmed mucosal recovery (vs. persistent damage) and reduced mortality independent of age and gender. Systematic follow-up with intestinal biopsies may be advisable in patients diagnosed with CD as adults.
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Cites
Celiac Disease and Risk of Liver Disease: A General Population-Based Study
Ludvigsson, J. F., Elfström, P., BroomÉ, U., Ekbom, A., & Montgomery, S. M. (2007) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2006.09.034 · Cited by 172
Cited by
Husby, S., Murray, J. A., & Katzka, D. A. (2019) · Gastroenterology · doi:10.1053/j.gastro.2018.12.010 · Cited by 274
Self-citationSilvester, J. A., Kurada, S., Szwajcer, A., Kelly, C. P., Leffler, D. A., & Duerksen, D. R. (2017) · Gastroenterology · doi:10.1053/j.gastro.2017.05.015 · Cited by 235
Biagi, F., Bianchi, P. I., Marchese, A., Trotta, L., Vattiato, C., Balduzzi, D., Brusco, G., Andrealli, A., Cisarò, F., Astegiano, M., et al. (2012) · British Journal of Nutrition · doi:10.1017/s0007114511007367 · Cited by 151
Silvester, J. A., Weiten, D., Graff, L. A., Walker, J. R., & Duerksen, D. R. (2016) · Nutrition · doi:10.1016/j.nut.2016.01.021 · Cited by 115
Atypical celiac disease as cause of increased need for thyroxine: a systematic study
Virili, C., Bassotti, G., Santaguida, M. G., Iuorio, R., Del Duca, S. C., Mercuri, V., Picarelli, A., Gargiulo, P., Gargano, L., & Centanni, M. (2012) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2011-1851 · Cited by 114
Metadata
- Authors
- Rubio-Tapia, A., Rahim, M. W., See, J. A., Lahr, B. D., Wu, T.-T., & Murray, J. A.
- Venue
- American Journal of Gastroenterology
- Published
- 2010-06
- Volume
- 105
- Issue
- 6
- Pages
- 1412-1420
- ISSN
- 0002-9270 (ISSN-L)
- OpenAlex
- W2044202223
- Cited by
- 403
- References
- 1
- FWCI
- 21.99
- Type
- journal article
- Language
- en
- Open access
- green
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