Mortality and causes of death in celiac disease in a Mediterranean area

No data on mortality in celiac disease are currently available in southern Europe. Our aim was to evaluate mortality and the cause of death in adult celiac disease in a Mediterranean area. In all, 228 adults with celiac disease were histologically diagnosed in our department from 1980 to 1997. Full information on their state of health was obtained in 216 of 228 patients. A tabulation of patient-years at risk was constructed in terms of age at diagnosis and the interval from diagnosis. Standardized mortality ratio was calculated by dividing the number of observed deaths by the number of expected deaths. Twelve deaths were observed, whereas 3.12 deaths were expected (SMR = 3.8; 95% CI 2-7). The increased mortality was mainly observed within four years from diagnosis (8 observed; 1.4 expected) (SMR = 5.8; 95% CI 2.5-11.5). Twelve tumors were observed (six lymphomas). In conclusion, mortality from adult celiac disease in our geographical area is increased compared with the general population, and this increased risk seems due to non-Hodgkin's lymphoma.

Mortality in patients with Crohn's disease

BACKGROUND

No data on mortality for Crohn's disease are available from southern Europe.

METHODS

Five hundred and thirty-one patients with Crohn's disease were observed in our unit between 1973 and 1993. In 325 patients the first diagnosis was made in our hospital. In this consecutive incidence series, in which the follow-up was 99% complete, the standardized mortality rate (SMR) was calculated.

RESULTS

Nine deaths were observed, against 9.25 expected. The SMR was 0.97 (95% confidence interval (CI), 0.4-1.8). The relative risk of dying was significantly higher in the female group in the first 5 years after diagnosis (SMR, 10.3; 95% CI, 2.30-30.2). There was an excess of deaths from tumors of the digestive organs (1 observed, 0.37 expected).

CONCLUSIONS

These results show that in our geographic area the mortality from Crohn's disease was not increased as shown in other community studies.

[Anti-islet cell antibodies in insulin-dependent diabetics. Preliminary study]

Anti-islet cell cytoplasm antibodies (ICA) were noted in the serum of insulin-dependent diabetics, but not in subjects with insulin-independent forms. These antibodies seem to represent an immunological marker for two forms of the disease, one in which ICA appears shortly after onset and later disappears, and another ("autoimmune") form in which ICA is detectable for long periods and persists along with other signs of alteration of the immune system.