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  • Review Article
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Mortality in celiac disease

Nature Reviews Gastroenterology & Hepatology volume 7, pages 158–162 (2010)Cite this article

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Abstract

Although the prevalence rates of celiac disease tend to be very similar in different Western populations, mortality rates for this disease vary widely. In this Review we focus on the papers that have addressed this issue so far. We evaluated mortality rates in different forms of celiac disease, such as symptomatic celiac disease, unrecognized celiac disease, dermatitis herpetiformis and refractory celiac disease. We also evaluated the role of possible protective factors, such as adherence to a gluten-free diet, early diagnosis and severity of clinical presentation. Finally, we noticed that the mortality rate for celiac disease seems to be higher in Southern than in Northern Europe and seems to correlate with 'national' gluten consumption. To explain these differences, we propose a hypothesis that links mortality rates to the amount of gluten consumed not only after but also before the diagnosis of celiac disease.

Key Points

  • Mortality rates in patients with celiac disease are increased compared with the general population

  • Reported mortality rates vary between studies

  • Increased mortality in patients with celiac disease is mainly due to malignancies

  • Overall, mortality rates decrease over time from diagnosis

  • Early diagnosis and a strict gluten-free diet are protective

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Figure 1
Figure 2: The relationship between the standard mortality rate for patients with symptomatic celiac disease (Denmark, Sicily, Italy, Sweden, UK and Finland) and pasta and bread consumption (r = 0. 66, P = 0.049 for Pearson linear regression).1,7,8,10,11,13,31,32,33

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Acknowledgements

We are grateful to S. West for reading and correcting the manuscript.

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Authors and Affiliations

  1. Coeliac Centre/First Department of Internal Medicine, Fondazione IRCCS Policlinico San Matteo, University of Pavia, P. le Golgi, 19, Pavia, 27100, Italy

    Federico Biagi & Gino R. Corazza

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  1. Federico Biagi
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  2. Gino R. Corazza
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Correspondence to Federico Biagi.

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The authors declare no competing financial interests.

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Biagi, F., Corazza, G. Mortality in celiac disease. Nat Rev Gastroenterol Hepatol 7, 158–162 (2010). https://doi.org/10.1038/nrgastro.2010.2

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