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Although mortality of patients with coeliac disease has being studied for >25 years, it is not yet clear whether it is higher than in the general population. In the first years after the diagnosis of coeliac disease, some studies showed a definitely increased mortality rate that, however, decreases over time. On the other hand, other studies showed that this was not always the case (reviewed in ref 1). All these studies are difficult to compare because they differ widely from each other for epidemiological and clinical reasons. To explain these apparently contrasting results, we suggested that mortality rates were different because patients with coeliac disease were different, especially regarding the type of clinical presentation and age at diagnosis of coeliac disease. We also hypothesised that the quantity of gluten consumed before the diagnosis of coeliac disease could have a role in inducing complications and thus influencing mortality rate.1
In the last few years, mortality of patients with coeliac disease was the focus of studies that were not based on clinically collected patients with coeliac disease but on data from patients with coeliac disease recorded in massive databases. The study by Sultan et al2 is one of them. This and other studies …
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