ArticleGut2023
Persistent villous atrophy predicts development of complications and mortality in adult patients with coeliac disease: a multicentre longitudinal cohort study and development of a score to identify high-risk patients.
Article in Gut, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 3 of them syntheses that pooled it.
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Who cites it
28 citing papers in PubMed, 3 syntheses or guidelines pooled it, 59 citations in OpenAlex.
- European Society for the Study of Coeliac Disease 2025 Updated Guidelines on the Diagnosis and Management of Coeliac Disease in Adults. Part 1: Diagnostic Approach.United European gastroenterology journal · 2025Guideline
- Pooled it
- Micronutrient deficiencies in patients with celiac disease: A systematic review and meta-analysis.International journal of immunopathology and pharmacologyPooled it
- Conference Report: The FutuRE oF MinimalLy InvasivE GI and Capsule DiagnosTics (REFLECT), September 2025.Diagnostics (Basel, Switzerland) · 2026Article
- Long-term risk of acute pancreatitis in patients with celiac disease: A nationwide population-based cohort study.Journal of internal medicine · 2026Article
- Risk of malignancy and surveillance of premalignant gastrointestinal lesions in adult celiac disease.Frontiers in oncology · 2026Review
- Healthcare resource utilization and cost in pediatric celiac disease: A case-control study using German insurance data.Journal of pediatric gastroenterology and nutrition · 2026Article
- Management Strategy for Non-Responsive and Refractory Celiac Disease in Adults: A Review Article.Journal of clinical medicine · 2025Review
- Nationwide survey of coeliac disease serology testing in the UK.BMJ open gastroenterology · 2025Article
- Outcomes in Adults with Celiac Disease Following a Gluten-Free Diet.Journal of clinical medicine · 2025Review
- Non-Celiac Villous Atrophy-A Problem Still Underestimated.Life (Basel, Switzerland) · 2025Review
- Diagnostic Challenges in Enteropathies: A Histopathological Review.Diagnostics (Basel, Switzerland) · 2025Review
- Limitations of Faecal Calprotectin in Detecting Histological Changes and Persistent Villous Atrophy in Patients With Coeliac Disease on a Gluten-Free Diet.Alimentary pharmacology & therapeutics · 2025Article
- Biopsy-Sparing Diagnosis of Coeliac Disease Based on Endomysial Antibody Testing and Clinical Risk Assessment.Alimentary pharmacology & therapeutics · 2025Article
- Coeliac disease: complications and comorbidities.Nature reviews. Gastroenterology & hepatology · 2025Review
- Long-term risk of chronic liver disease in patients with celiac disease: a nationwide population-based, sibling-controlled cohort study.The Lancet regional health. Europe · 2025Article
- Prevalence and Predictors of Follow-up Endoscopic Biopsy in Patients With Celiac Disease in the United States.Journal of clinical gastroenterology · 2025Article
- [Celiac disease: an update].Innere Medizin (Heidelberg, Germany) · 2025Review
- Restoration of the lamina propria duodenal immune infiltrate in gluten-free diet treated celiac patients despite persistent villous atrophy.Clinical and experimental immunology · 2025Article
- Gluten-Free Diet and Health-Related Quality of Life: The Validated Hellenic Version of the Celiac Dietary Adherence Test.Nutrients · 2025Article
Corrections and comments
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Authors and funding
13 authors at 4 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivePersistent villous atrophy (pVA) in coeliac disease (CD) despite a gluten-free diet (GFD) has unclear meaning. We aimed to (i) study the relationship between pVA and long-term outcomes and (ii) develop a score to identify patients at risk of pVA.
designThis is a multicentre retrospective-prospective study consisting of a study cohort (cohort 1) and an external validation cohort (cohort 2) of patients with biopsy-proven CD diagnosed between 2000 and 2021. Cohort 1 was used to (i) compare long-term outcomes between patients with and without pVA (Marsh ≥3a) at follow-up biopsy and (ii) to develop a score to evaluate the risk of pVA, which was validated in cohort 2.
resultsOf 2211 patients, 694 (31%) underwent follow-up duodenal biopsy and were included in the study cohort (491F, 44±16 years). 157/694 (23%) had pVA. Risk of complications (HR 9.53, 95% CI 4.77 to 19.04, p<0.001) and mortality (HR 2.93, 95% CI 1.43 to 6.02, p<0.01) were increased in patients with pVA. A 5-point score was developed and externally validated (receiver operating characteristic area under the curve 0.78, 95% CI 0.68 to 0.89) to stratify patients by risk of pVA: low (0-1 points, 5% pVA), intermediate (2 points, 16% pVA) and high (3-5 points, 73% pVA). Predictors for pVA used in the score were age at diagnosis ≥45 years (OR 2.01, 95% CI 1.21 to 3.34, p<0.01), classical pattern of CD (OR 2.14, 95% CI 1.28 to 3.58, p<0.01), lack of clinical response to GFD (OR 2.40, 95% CI 1.43 to 4.01, p<0.001) and poor GFD adherence (OR 48.9, 95% CI 26.1 to 91.8, p<0.001).
conclusionsRisk of complications and mortality were increased in patients with pVA. We developed a score to identify patients at risk of pVA and in need of histological reassessment and closer follow-up.
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