Mortality Markedly Increased in Children With Celiac Disease

Long-term all-cause mortality rates among people diagnosed with celiac disease in childhood are threefold higher than population mortality rates. Dr. Masoud Solaymani-Dodaran and associates from Queen’s Medical Centre, Nottingham, UK examined whether long-term mortality differed between patients diagnosed with celiac disease as children or as adults, compared with the general population.

Standardized all-cause mortality ratios more than 5 years after diagnosis of celiac disease were 3.32 with a childhood diagnosis, but only 1.38 for patients diagnosed as adults, the report indicates.

The excess mortality risk among people diagnosed when they were children was mainly accounted for by deaths from accidents, suicide, and violence, malignancies, and cerebrovascular diseases. In contrast, malignant neoplasms were the main contributor to excess mortality in adults, the researchers note.

"The increase of long-term mortality, i.e., greater than 5 years after diagnosis, we have found with childhood-diagnosed celiac disease was fairly unexpected and is in marked contrast to the pattern seen with adult diagnosed disease in our study," the investigators say.

"Adults diagnosed with celiac disease had only a reassuringly small increase of long-term mortality, which is, for comparison, only about half that seen in Crohn’s disease," they note. "In contrast, children diagnosed with celiac disease had an increase of long-term mortality, most of which was difficult to attribute directly to the disease itself."

The absolute mortality increase with a childhood diagnosis was small, Dr. Solaymani-Dodaran and colleagues note, but "the excess of deaths from accidents, suicides, and violence is cause for concern."

Am J Gastroenterol  April, 2007;102:864-870.

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