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Mortalidad en pacientes con enfermedad celíaca y sus familiares: un estudio de cohorte
G Corrao1, G R Corazza, V Bagnardi
1Cattedra di Statistica Medica, Università di Milano-Bicocca, 20126, Milano, Italy. giovanni.corrao@unimib.it
Lancet (London, England)
|August 15, 2001
Resumen
La mortalidad en pacientes con enfermedad celíaca es el doble de la tasa esperada, especialmente dentro de los 3 años posteriores al diagnóstico o con síntomas de malabsorción. Las estrictas dietas sin gluten reducen significativamente este riesgo.
Área de la Ciencia:
- Gastroenterología y Gastroenterología.
- Epidemiología Clínica Epidemiología clínica.
- Oncología Oncología.
Sus antecedentes:
- Estudios previos indican una elevada mortalidad en pacientes con enfermedad celíaca (EC) y sus familiares.
- Faltan datos sobre los patrones de mortalidad relacionados con la presentación clínica de la CD.
Objetivo del estudio:
- Para evaluar la mortalidad en pacientes con enfermedad celíaca y sus familiares de primer grado.
- Para investigar el impacto de la presentación clínica en la mortalidad de los pacientes con CD.
Principales métodos:
- Estudio de cohorte prospectivo de 1072 pacientes adultos con CD diagnosticados entre 1962-1994.
- La inclusión de 3384 parientes de primer grado.
- Comparación de las muertes observadas con las muertes esperadas utilizando la relación de mortalidad estandarizada (SMR).
Principales resultados:
- Los pacientes con enfermedad celíaca mostraron un aumento de la mortalidad 2 veces mayor (SMR 2.0).
- El exceso de mortalidad fue significativo dentro de los 3 años posteriores al diagnóstico, particularmente en aquellos con síntomas de malabsorción (SMR 2.5).
- El diagnóstico tardío y el cumplimiento deficiente de la dieta libre de gluten se correlacionaron con un aumento de la RMS; El linfoma no Hodgkin fue la principal causa de muerte.
Conclusiones:
- El diagnóstico rápido y la adherencia estricta a una dieta libre de gluten son cruciales para reducir la mortalidad en la enfermedad celíaca.
- Se necesita más investigación para comprender la progresión de la enfermedad de Huntington leve / asintomática y su relación con el linfoma intestinal.
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