Ludvigsson JF, Montgomery SM, Ekbom A et al.
Örebro University Hospital, Örebro, Sweden.
JAMA 2009;302:1171–8.
Editor’s note: This major retrospective epidemiological and histological study examines the impact of histopathological findings in celiac disease on mortality. Data were collected from duodenal biopsies taken between July 1969 and February 2008 in patients with celiac disease from all 28 pathology departments in Sweden. These cases were divided into two cohorts, the first being celiac disease with Marsh stage 3 (i.e. villous atrophy), and comprised >29 000 individuals. The second cohort comprised those with inflammation, (i.e. Marsh stages 1 and 2), and comprised 13 306 individuals. A third cohort consisted of individuals (n=3719) with latent celiac disease collected from eight university hospitals. Latent celiac disease was defined as positive celiac serology with histologically normal mucosa. Using linkage with the Swedish total population register, the estimated risk of death to 31 Aug 2008 was compared with age- and sex-matched control subjects from the general population.