Celiac Disease: A Forty-Year Analysis in an Italian Referral Center

Celiac disease (CD) is an autoimmune disorder triggered by gluten ingestion. Herein, we assessed clinical, serological and histopathological findings of a single-center, large cohort of CD patients diagnosed and followed-up over forty years. From January 1980 to December 2020, 1547 CD patients (1170...

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Bibliographic Details
Published in:Nutrients 2024-07, Vol.16 (14), p.2292
Main Authors: Lungaro, Lisa, Costanzini, Anna, Manza, Francesca, Caputo, Fabio, Remelli, Francesca, Volpato, Stefano, De Giorgio, Roberto, Volta, Umberto, Caio, Giacomo
Format: Article
Language:English
Subjects:
Adolescent
Adult
Age
Aged
Aged, 80 and over
Antibodies
Asymptomatic
Atrophy
Biopsy
Celiac disease
Celiac Disease - epidemiology
Child
clinical features
Comorbidity
Diarrhea
Female
Genotype & phenotype
Gluten
Histology
Humans
Immunoglobulins
Investigations
Italy - epidemiology
Lymphoma
Male
Middle Aged
natural history
osteoporosis
Peptides
refractory celiac disease
Serology
Tertiary Care Centers - statistics & numerical data
Young Adult
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Summary:Celiac disease (CD) is an autoimmune disorder triggered by gluten ingestion. Herein, we assessed clinical, serological and histopathological findings of a single-center, large cohort of CD patients diagnosed and followed-up over forty years. From January 1980 to December 2020, 1547 CD patients (1170 females; age range: 8-81 years; F:M ratio = 3.1:1) were diagnosed in an Italian tertiary referral center. Comorbidities and complications were recorded at diagnosis and during follow-up. CD diagnoses quadrupled after 2000. The most frequent phenotype was the non-classical CD (63.3%), and the most prevalent histotype was Marsh 3C (44.7%). Gastrointestinal manifestations, detectable in 51% of patients, were diarrhea (24.3%), bloating (28%) and aphthous stomatitis (19.7%). The most common CD-associated disorder was osteopenia (59.9%), predominant in females (64.3%); extraintestinal manifestations included anemia (35.8% iron-deficiency; 87% folic acid malabsorption), cryptogenic hypertransaminasemia (27.9%), and recurrent miscarriages (11.5%). Thyroiditis (26.9%), type 1 diabetes mellitus (2.9%), and dermatitis herpetiformis (1.4%) were the most common CD-related autoimmune disorders. Six patients had inflammatory bowel disease. Complications and mortality rate occurred in 1.8% and 1.9%, respectively. This single-center, large cohort analysis confirmed that CD presentation changed over the years, with an increase of non-classical and subclinical clinical phenotypes.
ISSN:2072-6643
2072-6643
DOI:10.3390/nu16142292