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    Long-Term Mortality in People With Celiac Disease Diagnosed in Childhood Compared With Adulthood: A Population-Based Cohort Study


    Jefferson Adams
    Image Caption: Photo: CC - jimmedia

    Celiac.com 04/04/2012 - After numerous studies over several decades showing higher mortality rates in people with celiac disease, including a comprehensive study in 2009, published in Gastroenterology, news of a recent UK study, finding mortality rates for people with untreated celiac disease that are similar to the general population, has raised a few eyebrows.


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    Photo: CC - jimmediaWith diverse study data fueling differing opinions, questions regarding long-term mortality in people with celiac disease will likely take time to resolve.

    In the meantime, a review of scientific literature brought up this small 2007 study. In it, a research team compared long-term mortality rates in people diagnosed with celiac disease as children with rates for those diagnosed as adults. They wanted to find out how those rates might differ and if the rates might be related to the disease and the length of gluten exposure before diagnosis.

    To find an answer, the team gathered data for 285 children and 340 adults diagnosed with celiac disease. They continued to gather data for each until the end of 2004, excepting those who failed to follow up for other reasons.

    From their data, the team calculated standardized mortality ratios (SMRs) for the period starting five years after patient diagnosis. They found that adults diagnosed with celiac disease had 38% higher mortality rates (SMR 1.38, 95% CI 1.16-1.63). Children on the other hand, faced rates three-times higher (SMR 3.32, 95% CI 2.05-5.07).

    This excess mortality in children was mainly due to higher rates of death from accidents, suicide, and violence (seven deaths, SMR 3.22, 95% CI 1.29-6.63), cancer (five deaths, SMR 3.72, 95% CI 1.21-8.67), and cerebrovascular disease (two deaths, SMR 10.03, 95% CI 1.21-36.00).

    The 2007 study found that adults with celiac disease face a modest increase in mortality rates over the long-term, but that mortality rates for those diagnosed with celiac disease as children were three-times higher starting five years after diagnosis.

    The team proposed that the increased mortality in children from external causes may be due to behavioral changes associated with living with life-long celiac disease and its treatment.

    Stay tuned for further developments regarding mortality rates in people with celaic disease.

    Source:


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    Guest Dr Berylium

    Posted

    This article really didn't tell us anything at all, and the statistics aren't explained well. The lousy content is more the fault of the authors of the study, not the article, however.

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    Guest Lori Muir

    Posted

    Mental and physical health are dramatically affected by gluten...however... I did not begin to heal until I went not only gluten free but also LOW FODMAP.

     

    I think these docs are missing the boat here... I can't even get one to give me a fructose intolerance test..say they can't find the "codes" for billing to order it... I gave up on confirmation of fructose intolerance... I went to lactose free milk...no longer eat onions, garlic, cabbage family veggies, cut out some types of beans...these things and other high fodmap fruits and veggies...like apples, pears, berries, watermelon, cantelope, oranges. Things I thought were good for me were making me feel suicidal and causing much insomnia, IBS, and pain...

     

    Now that I stick to my low fodmap plan..I feel healthy again for the first time in 15 years, but...now....when I screw up (and inadvertently, that happens a lot)... the pins and needles, arms and legs going numb, even my head goes numb at times, will start within minutes now of eating the offending foods, and depression thoughts will last for two days, with fatigue.

     

    I was so sick prior to this, and I had these symptoms constantly, so I never associated the symptoms with foods. I just thought I was dying, and being diagnosed with fibromyalgia, chronic fatigue, nueralgia, IBS... chronic LYME disease... I could go on here, but the point is... none of my 28 docs, surgeons, specialists EVER said A WORD about food being the cause....even when I would tell them... things like... " Every time I eat a bowl of raisin bran, on those days...my vision gets so blurry and double I cannot see for rest of the day" .... or "When I drink orange juice, I start to heat up and sweat".... they brushed it off...as some SYNDROME SYMPTOM, or menopause...and wanted to give me more drugs...every time!

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    Guest Marsha

    Posted

    Not current and not enough information to substantiate facts given.

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    The article states that they calculated ratios five years after diagnosis but they don't specify if the patients were on a strict gluten-free diet or if there levels were tested to suggest adherence to the diet. The article leaves you confused and it could be that the study did not list the specifics....either way, wish we had more details.

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    This study seems flawed to me. It is essentially comparing mortality rates of children vs. mortality rates of adults. Celiac is not the main variable. In order for this study to be meaningful the researchers would need many more years of data and to make an apples to apples comparison.

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  • About Me

    Jefferson Adams is a freelance writer living in San Francisco. He has covered Health News for Examiner.com, and provided health and medical content for Sharecare.com. His work has appeared in Antioch Review, Blue Mesa Review, CALIBAN, Hayden's Ferry Review, Huffington Post, the Mississippi Review, and Slate, among others.

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  • Related Articles

    Jefferson Adams
    Celiac.com 07/28/2010 - Most people with celiac disease keep themselves healthy by following a gluten free diet. More and more, doctors are recognizing the importance of confirming gut recovery through follow-up evaluation. Still, among clinicians, there is currently no standard for follow-up confirmation of gut healing in celiac disease treatment.
    Many guidelines recommend an initial follow-up biopsy at 4-6 months after the patient begins a gluten-free diet. However, the use of biopsy to confirm gut healing is still controversial, as it can yield enormously variable results.
    A group of researchers recently set out to establish the amount of time it takes for full gut recovery in patients with celiac disease.
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    The team reviewed histopathology reports for all duodenal biopsies, and scored each biopsy for histopathology based on a modified Marsh grade.
    The team indexed and performed at least one biopsy on two hundred and eighty-four patients.
    The team found marked gut improvement in two-hundred and twenty-seven patients (80%), and a complete return to normal histology in 100 patients (35%). Average recovery time was 1.9 years, with a range of 1.0–4.8 years.
    Patients with less serious celiac disease at the start showed a better overall response (r = 0.281, P < 0.0001), while older patients recovered more quickly (r = –0.200, P = 0.001).
    Patients who best followed a gluten-free diet showed the best biopsy scores (r = –0.134, P = 0.040) and the greatest degree of histological recovery (r = 0.161, P = 0.014).
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    These results shows histological recovery generally takes longer than traditionally thought, and that doctors looking to conduct such follow-ups might do well to factor in the patient’s age at diagnosis, the initial disease score, as well as the level of compliance with a gluten free diet.
    Source:

    QJM 2010 103(7):511-517

    Destiny Stone
    Celiac.com 08/18/2010 - The importance of an accurate celiac disease diagnosis is becoming increasinglymore evident to health practitioners and the general public worldwide. While the outcomes of undiagnosed celiac disease are still unclear,current  studies are attempting to find an answer.
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    Gastroentrology doi:10.1053/j.gastro.2010.05.041

    Jefferson Adams
    Celiac.com 09/13/2010 - What's happening in with the immune system when a child is first diagnosed with celiac disease? What happens when they are treated with a gluten-free diet?
    Some recent studies have indicated that both the adaptive and the innate immune system play roles in celiac disease. However, until now, doctors haven't known much about the immune phenotype of children with celiac disease and how that phenotype might by affected by a gluten-free diet.
    To move toward a better understanding of these issues, a team of researchers recently studied immune phenotype in children with either newly diagnosed celiac disease, or celiac disease treated with a gluten-free diet.
    The research team included Áron Cseh, Barna Vásárhelyi, Balázs Szalay, Kriszta Molnár, Dorottya Nagy-Szakál, András Treszl, Ádám Vannay, András Arató, Tivadar Tulassay and Gábor Veres. The are affiliated with the First Department of Pediatrics in the Research Group for Pediatrics and Nephrology at Semmelweis University and Hungarian Academy of Sciences, in Budapest, Hungary.
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    Most of these deviations returned to normal, once symptoms subsided with gluten-free diet treatment. However, prevalence of NK and NKT cell, DC and TLR-2 expressing DCs and monocytes remained abnormal.
    The immune phenotype in childhood celiac disease indicates that both adaptive and innate immune systems are playing a role in celiac disease.
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    Source:

    Dig Dis Sci. 2010 Aug 5. DOI: 10.1007/s10620-010-1363-6

    Jefferson Adams
    Celiac.com 02/10/2012 - The HBV vaccine is usually effective against common hepatitis B virus (HBV) infection, with just 4-10% of vaccine recipients failing to respond to standard immunization. Some studies suggest that people with celiac disease may have high levels of resistance to the HBV vaccine, compared to the general population.
    A team of researchers recently took a look at the issue of HBV vaccine reliability in people with celiac disease.
    The study team included Mohammad Rostami Nejad, Kamran Rostami, and Mohammad Reza Zali. They are variously affiliated with the Research Center for Gastroenterology and Liver Disease at Shahid Beheshti University of Medical Sciences in Tehran, Iran, and with Acute Medicine at Dudley Group of Hospital in Dudley, UK. Together, they reviewed data from previous studies.
    The ability to respond to recombinant HBV vaccine is associated with certain gene sites. At those sites, certain HLA haplotypes, such as B8, DR3, and DQ2 are common genetic markers among non-responders.
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    The data fits with previous studies that confirm the findings that children with celiac disease fail to respond to the HBV vaccine at significantly higher rates than do healthy children.
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    Another study, by Stachowski et al., further cemented this connection between HLA and non-responsiveness to HBV vaccine. In that study, 34 out of 153 patients with end-stage renal disease failed to respond to HBV vaccine, and HLA-DQ2 was found almost exclusively in the non-responder group.
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    This study was not designed to assess the presence of HLA-DQ2 and HLA-DQ8 in the groups. Therefore, future studies assessing HLA haplotypes in celiac disease should seek to describe the role of HLA typing in response to HBV vaccination.
    The evidence indicates that early diagnosis of celiac disease, and treatment with a gluten-free diet may increase the overall percentage of patients responding favorably to the HBV vaccine.
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    The review team points out that the high prevalence of celiac disease in the general population and a lack of response to HBV vaccine in untreated patients, invites routine assessment in patients with celiac disease receiving the HBV vaccine.
    Lastly, the review team notes that non-responsiveness to HBV vaccine may indicate undiagnosed celiac disease or noncompliance with gluten-free diet.
    SOURCE:
    Hepat Mon. 2011 August 1; 11(8): 597–598.
    doi:  10.5812/kowsar.1735143X.761


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    Jefferson Adams
    Celiac.com 07/17/2018 - What can fat soluble vitamin levels in newly diagnosed children tell us about celiac disease? A team of researchers recently assessed fat soluble vitamin levels in children diagnosed with newly celiac disease to determine whether vitamin levels needed to be assessed routinely in these patients during diagnosis.
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    Jefferson Adams
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    Source:
    J Clin Gastroenterol