Prof Giovanni Corrao

Findings

53 coeliac patients died compared with 259 expected deaths (SMR 20 [95% CI 15-27]). A significant excess of mortality was evident during the first 3 years after diagnosis of coeliac disease and in patients who presented with malabsorption symptoms (25 [18-34]), but not in those diagnosed because of minor symptoms (11 [05-22]) or because of antibody screening (12 [01-70]). SMR increased with increasing delay in diagnosis and for patients with poor compliance with gluten-free diet. Non-Hodgkin lymphoma was the main cause of death. No excess of deaths was recorded in relatives with coeliac disease.

Interpretation

Prompt and strict dietary treatment decreases mortality in coeliac patients.

Prospective studies are needed to clarify the progression of mild or symptomless coeliac disease and its relation to intestinal lymphoma.

Lancet 2001; 358: 356-61

Science. 2001; 291: 2536-2541

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