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Celiac disease, characterized by the presence of villous atrophy (VA) in the small intestine, is associated with increased mortality, but it is unknown if mortality is influenced by mucosal recovery.
Dr Ludvigsson and colleagues from Sweden determined whether persistent villous atrophy is associated with mortality in celiac disease.
Through biopsy reports from all pathology departments in Sweden, the researchers identified 7648 individuals with celiac disease who had undergone a follow-up biopsy within 5 years following diagnosis. The research team found that the mean age of celiac disease diagnosis was 28.  | | Persistent villous atrophy was present in 43% | | Alimentary Pharmacology & Therapeutics |
The team noted that 63% were female, and the median follow-up after diagnosis was 12 years. The overall mortality rate of patients who underwent follow-up biopsy was lower than that of those who did not undergo follow-up biopsy. Of the 7648 patients who underwent follow-up biopsy, persistent villous atrophy was present in 43%. The team observed that there were 8% deaths. Patients with persistent villous atrophy were not at increased risk of death compared with those with mucosal healing. Mortality was not increased in children with persistent villous atrophy or adults, including adults older than age 50 years.
Dr Ludvigsson's team concludes, "Persistent villous atrophy is not associated with increased mortality in celiac disease." "While a follow-up biopsy will allow detection of refractory disease in symptomatic patients, in the select population of patients who undergo repeat biopsy, persistent villous atrophy is not useful in predicting future mortality."
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