cd mortality
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KI 2009
Mortality in celiac disease
Jonas F. Ludvigsson
Earlier studies
0
1
2
3
4
Collin Viljamaa West Logan Peters Corrao Solaym. Nielsen CottoneAnderss.Metzger
Celiac Disease Positive Serology
Biopsi
28
CD serology data from 8 university hospitals
Latent CD, Normal mucosa but positiv CD serology
Validation
Questionnaries:1. Gastroenterol.2. Pediatricians3. Pathologists
Interobserver reliability
Patient Chart Reviews
Linkage toCD serology data
Normal Borderline Villous atr.
Normal 74 (96%) 3 0 77
Borderline 12 22 (56%) 5 39
Villous atr. 2 18 190 (90%) 210
Total 88 43 195 326
Interobserver reliability
96%
4%1%
9-10/10 5-8/101-4/10 Never
Adults: 96%
N = 180100%
Children: 100%
N = 68
Biopsy prior to CD diagnosis
Villous atrophy is clinical CD in 95% of cases
95%
5%
CD Not CD
Is villous atrophy equal to CD?
79% of the validated individuals with VA and 64% of those with inflammation had documented gastrointestinal symptoms prior to biopsy.
88% of the validated individuals with VA had positive CD serology before their first biopsy.
Is villous atrophy equal to CD?
3,700 13,400
29,000
Overall mortality
HR 95% CI for HR p-value Number of
deaths
Reference 1.00 1.00 23,633
CD 1.39 (1.33-1.45) 5.42527 E-53 3,049
Inflammation 1.72 (1.64-1.79) 2.7082 E-130 2,967
Latent CD 1.35 (1.14-1.58) 0.00034 183
Subanalyses
Increased mortality:All age groups including children
No difference over calendar periodNo difference between males/females
Low absolute risks
The End
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