Joseph Murray, M. D., discusses a journal article published in Alimentary Pharmacology & Therapeutics about refractory celiac disease in countries that have a high-rate of diagnosed celiac disease.
Celiac disease in Scandinavian populations may affect more than 100 people. Finland is unique because a greater portion of patients with celiac disease are diagnosed. Most patients in Finland respond well to a gluten-free diet and report the highest rate of intestinal healing.
This study examined a particular area of Finland and incorporated 11 different hospital districts. The researchers counted all of the patients diagnosed with celiac disease in the group of 12,000 and identified a small number of patients had developed refractory celiac disease. Refractory celiac disease is an especially rare and complicated case of celiac disease in which patients have relapsing symptoms of malabsorption and continue damaging the intestine. The number of patients identified with refractory celiac disease in this study suggest that less than one third of 1% of patients identified with celiac disease develop refractory celiac disease.
There are two groups within refractory celiac disease. Type one is called immune refractory celiac disease. Type two is a more premalignant type of refractory celiac disease. In the Finnish population of this study, only one third of the patients with refractory celiac disease had type two refractory celiac disease.
The results of this study suggest that celiac disease rarely results in refractory celiac disease, and there may be a tendency to over diagnose refractory celiac disease in many populations. Who tends to develop refractory celiac disease? Older, male patients who are seronegative at the time of diagnosis.
Dr Murray says while refractory celiac disease is an important condition, it is not such a big worry for patients who have celiac disease.
Read the full study online here.
For more information about celiac disease, visit mayoclinic.org/celiacdisease.
Dr. Murray is a gastroenterologist and celiac disease expert at Mayo Clinic.