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Characteristics and Long-Term Prognosis of Celiac Disease: Comparisons between Patients Diagnosed either in Childhood
Sara Koskimaa1,2, Samuli Nurminen1,2, Teea Salmi2,3
1Tampere Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
Introduction:
It is plausible but not yet proven that early celiac disease diagnosis prevents long-term complications of untreated disease. Our aim was to compare phenotype and health outcomes in currently adult celiac disease patients diagnosed either in childhood (<18 years) or adulthood.
Methods:
Data on 1,059 patients were collected from medical records at diagnosis and with questionnaires and structured interviews after long-term follow-up. Associations between timing of diagnosis and long-term health were studied with regression models.
Results:
Patients diagnosed in childhood (n = 239) were more often males (32% vs. 23%, p = 0.004), currently younger (27 vs. 54 years, p < 0.001), more often screen-detected (20% vs. 14%, p < 0.001), and reported lower adherence to gluten-free diet in adulthood (92% vs. 97%, p < 0.001) than those diagnosed in adulthood (n = 820). After adjusting for clinico-demographic variables and dietary adherence, patients diagnosed in childhood had fewer miscarriages (odds ratio 0.41 [95% confidence interval: 0.21-0.80]) but more allergies (1.75 [1.11-2.76]), dermatological diseases excluding dermatitis herpetiformis (1.99 [1.11-3.58]), asthma (2.28 [1.16-4.48]), and depression (2.84 [1.24-6.50]) in adulthood. The groups were comparable in other comorbidities including type 1 diabetes and autoimmune thyroidal diseases, persistent symptoms, and quality of life.
Conclusion:
Diagnosis in childhood compared to adulthood was associated with disease phenotype and its effects on long-term comorbidities are complex.
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