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Predictors of persistent villous atrophy in celiac disease

The latest issue of the Alimentary Pharmacology & Therapeutics identifies predictors of persistent villous atrophy in celiac disease.

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Villous atrophy with intraepithelial lymphocytosis is the histological hallmark of celiac disease, but reported rates of mucosal recovery are variable.

Dr Ludvigsson and colleagues from Sweden determined the impact of age and other demographic variables on the probability of persistent villous atrophy on follow-up biopsy.

The researchers identified patients with villous atrophy on duodenal histology at all 28 Swedish pathology departments during the years spanning 1969–2008.

The team examined age, gender, calendar period, duration of disease and educational attainment to determine predictors of persistent villous atrophy.

Of 7648 patients with celiac disease who underwent follow-up biopsy, persistent villous atrophy was present in 3317.

Persistent villous atrophy did not vary widely by age in earlier years
Alimentary Pharmacology & Therapeutics

The effect of age on persistent villous atrophy varied according to time period.

The team noted that among those biopsied in the years spanning 2000–2008, the prevalence of persistent villous atrophy was 31%, and increasing age was associated with increasing rates of persistent villous atrophy.

In contrast, the researchers observed that persistent villous atrophy did not vary widely by age in earlier years.

On multivariate analysis, persistent villous atrophy was more common among males, and less common among patients with higher educational attainment.

Dr Ludvigsson's team concludes, "The prevalence of persistent villous atrophy has changed over time, with greater rates of healing in recent years."

"Social differences in persistent villous atrophy suggest that access and/or education regarding the gluten-free diet impact mucosal healing."

Aliment Pharmacol Ther 2014: 39(5): 488–495
14 February 2014

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