Introduction It has been shown that mortality rates of coeliac patients correlate with age at diagnosis of coeliac disease, diagnostic delay for coeliac disease, pattern of clinical presentation and HLA typing. Our aim was to create a tool that identifies coeliac patients at higher risk of developing complications. Methods To identify predictors of complications in patients with coeliac disease, we organised an observational multicenter case-control study based on a retrospective collection of clinical data. Clinical data from 116 cases (patients with complicated coeliac disease) and 181 controls (coeliac patients without any complications) were collected from seven European centres. For each case, one or two controls, matched to cases according to the year of assessment, gender and age, were selected. Diagnostic delay, pattern of clinical presentation, HLA typing and age at diagnosis were used as predictors. Results Differences between cases and controls were detected for diagnostic delay and classical presentation. Conditional logistic models based on these statistically different predictors allowed the development of a score system. Tertiles analysis showed a relationship between score and risk of developing complications. Discussion A score that shows the risk of a newly diagnosed coeliac patient developing complications was devised for the first time. This will make it possible to set up the follow-up of coeliac patients with great benefits not only for their health but also for management of economic resources. Conclusions We think that our results are very encouraging and represent the first attempt to build a prognostic score for coeliac patients.
Dubé C, Rostom A, Sy R, Cranney A, Saloojee N, et al. (2005) The prevalence of celiac disease in average-risk and at-risk Western European populations: a systematic review. Gastroenterology 128 (4 Suppl 1)S57–67.
Biagi F, Gobbi P, Marchese A, Borsotti E, Zingone F, et al.. (2013) Low incidence but poor prognosis of complicated coeliac disease: a retrospective multicentre study. Dig Liver Dis http://dx.doi.org/10.1016/j.dld.2013.10.？010.
Biagi F, Lorenzini P, Corazza GR. (2000) Literature review on the clinical relationship between ulcerative jejunoileitis, coeliac disease, and enteropathy-associated T-cell. Scand J Gastroenterol 35: 785–790.
Al-Toma A, Verbeek WH, Hadithi M, von Blomberg BM, Mulder CJ (2007) Survival in refractory coeliac disease and enteropathy-associated T-cell lymphoma: retrospective evaluation of single-centre experience. Gut 56: 1373–1378.
Al-Toma A, Goerres MS, Meijer JWR, Pe？a AS, Crusius JB, et al. (2006) Human leukocyte antigen-DQ2 homozygosity and the development of refractory celiac disease and enteropathy associated T-cell lymphoma. Clin Gastroenterol Hepatol 4: 315–319.