Celiac disease natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
If left untreated, [#]% of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
OR
Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].
OR
Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [#]%.
Natural History, Complications, and Prognosis
Natural History
- There are different unknown variations of celiac disease which include:
- Asymptomatic
- Silent: Asymptomatic and no disease manifestation including evident malabsorption
- Potential: Positive celiac-specific serology with normal histology
- Natural history of these celiac disease variations is not completely understood. Particularly, the long-term risk of complications in patients who are asymptomatic or silent is not available.
- Clinical presentations in celiac disease have been described as an iceberg model. Based on the iceberg model of celiac disease, the classic malabsorption manifestation of disease is just the tip of the iceberg, and other more specific manifestations are invisible below the waterline. Based on iceberg model of celiac disease, the traditional method of diagnosing celiac disease based on malnutrition manifestations is unreliable due to different disease variation with more subtle manifestations whom were unrecognized.
- Undiagnosed celiac disease has been shown to be associated with a nearly 4-fold increased risk of death compared with asymptomatic patients whom are negative for serologic evidence of celiac disease.
- As the risk of malignancy in celiac disease exist, it is recommended to asymptomatic and silent patients should patients to comply with a gluten-free diet
- most people with either diagnosed or undiagnosed coeliac disease have only minor symptoms that are more inconvenient than life threatening
- The few data available regarding quality of life of patients with coeliac disease suggest that health‐related quality of life and psychological general well‐being are poor in undiagnosed patients, and improve with treatment in men but not significantly in women.
- In the US, 1612 respondents to a postal questionnaire reported a mean duration of symptoms for 11 years before the diagnosis of coeliac disease was made; after treatment 77% had an improved quality of life.
A high prevalence of depression was well documented in patients with coeliac disease.9548616
The adult patients with celiac disease are at higher risk of:
- Mortality from malignancy especialli lymphomas in patients aged 45-65
- Suicide
- Diabetes
- Inflammatory bowel disease
- The symptoms of (disease name) usually develop in the first/ second/ third decade of life, and start with symptoms such as ___.
- The symptoms of (disease name) typically develop ___ years after exposure to ___.
- If left untreated, [#]% of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
Complications
- B12 deficiency
- Iron deficiency
- Folate deficiency
- Anemia
- Hypoalbuminemia
- Osteoporosis
- Osteomalacia
- Increased risk of small bowel lymphoma
Prognosis
- Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [#]%.
- Depending on the extent of the [tumor/disease progression/etc.] at the time of diagnosis, the prognosis may vary. However, the prognosis is generally regarded as poor/good/excellent.
- The presence of [characteristic of disease] is associated with a particularly [good/poor] prognosis among patients with [disease/malignancy].
- [Subtype of disease/malignancy] is associated with the most favorable prognosis.
- The prognosis varies with the [characteristic] of tumor; [subtype of disease/malignancy] have the most favorable prognosis.