{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T12:27:06Z","timestamp":1783945626934,"version":"3.55.0"},"reference-count":36,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2012,11,28]],"date-time":"2012-11-28T00:00:00Z","timestamp":1354060800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2013,2]]},"abstract":"Summary<\/jats:title>Background<\/jats:title>Coeliac disease (CD<\/jats:styled-content>), characterised by the presence of villous atrophy (VA<\/jats:styled-content>) in the small intestine, is associated with increased mortality, but it is unknown if mortality is influenced by mucosal recovery.<\/jats:p><\/jats:sec>Aims<\/jats:title>To determine whether persistent VA<\/jats:styled-content> is associated with mortality in CD<\/jats:styled-content>.<\/jats:p><\/jats:sec>Methods<\/jats:title>Through biopsy reports from all pathology departments (n<\/jats:italic>\u00a0=\u00a028) in Sweden, we identified 7648 individuals with CD<\/jats:styled-content> (defined as VA<\/jats:styled-content>) who had undergone a follow\u2010up biopsy within 5\u00a0years following diagnosis. We used Cox regression to examine mortality according to follow\u2010up biopsy.<\/jats:p><\/jats:sec>Results<\/jats:title>The mean age of CD<\/jats:styled-content> diagnosis was 28.4; 63% were female; and the median follow\u2010up after diagnosis was 11.5\u00a0years. The overall mortality rate of patients who underwent follow\u2010up biopsy was lower than that of those who did not undergo follow\u2010up biopsy (Hazard Ratio 0.88, 95% CI<\/jats:styled-content>: 0.80\u20130.96). Of the 7648 patients who underwent follow\u2010up biopsy, persistent VA<\/jats:styled-content> was present in 3317 (43%). There were 606 (8%) deaths. Patients with persistent VA<\/jats:styled-content> were not at increased risk of death compared with those with mucosal healing (HR<\/jats:styled-content>: 1.01; 95% CI<\/jats:styled-content>: 0.86\u20131.19). Mortality was not increased in children with persistent VA<\/jats:styled-content> (HR<\/jats:styled-content>: 1.09 95% CI<\/jats:styled-content>: 0.37\u20133.16) or adults (HR<\/jats:styled-content> 1.00 95% CI<\/jats:styled-content>: 0.85\u20131.18), including adults older than age 50\u00a0years (HR<\/jats:styled-content>: 0.96 95% CI<\/jats:styled-content>: 0.80\u20131.14).<\/jats:p><\/jats:sec>Conclusions<\/jats:title>Persistent villous atrophy<\/jats:styled-content> is not associated with increased mortality in coeliac disease<\/jats:styled-content>. While a follow\u2010up biopsy will allow detection of refractory disease in symptomatic patients, in the select population of patients who undergo repeat biopsy, persistent villous atrophy is not useful in predicting future mortality.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.12164","type":"journal-article","created":{"date-parts":[[2012,11,29]],"date-time":"2012-11-29T00:17:25Z","timestamp":1354148245000},"page":"332-339","source":"Crossref","is-referenced-by-count":104,"title":["Mucosal healing and mortality in coeliac disease"],"prefix":"10.1111","volume":"37","author":[{"given":"B.","family":"Lebwohl","sequence":"first","affiliation":[{"name":"Celiac Disease Center Department of Medicine Columbia University College of Physicians and Surgeons New York NY USA"},{"name":"Clinical Epidemiology Unit Department of Medicine Karolinska University Hospital and Karolinska Institutet Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Granath","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology Unit Department of Medicine Karolinska University Hospital and Karolinska Institutet Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Ekbom","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology Unit Department of Medicine Karolinska University Hospital and Karolinska Institutet Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. M.","family":"Montgomery","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology Unit Department of Medicine Karolinska University Hospital and Karolinska Institutet Stockholm Sweden"},{"name":"Clinical Epidemiology and Biostatistics Unit \u00d6rebro University Hospital \u00d6rebro University \u00d6rebro Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. A.","family":"Murray","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Department of Medicine Mayo Clinic College of Medicine Rochester NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Rubio\u2010Tapia","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Department of Medicine Mayo Clinic College of Medicine Rochester NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. H. 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