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Complications of coeliac disease include:

  • osteoporosis
    • coeliac disease is associated with reduced bone mineral density
  • malignancy:
    • intestinal lymphoma, usually of T-cell derivation
    • 80-fold increase in small bowel carcinoma
    • increased incidence of extra-intestinal carcinoma, particularly, oesophageal carcinoma; rarely, of other organs, for example, bladder, brain, breast
  • ulcerative jejunitis - which may precede, accompany, or follow malignancy
  • hyposplenism
    • results in an increase in risk of infection from encapsulated bacteria
  • collagenous sprue - excessive subepithelial collagen deposition; may cause refractoriness to gluten withdrawal

The increased risk of malignancy appears to be unrelated to disease duration but is reduced in those compliant with a gluten-free diet.


  • a study examined the risk of malginancy in patients with undiagnosied coeliac disease
    • a population-based adult-representative cohort of 8000 individuals was drawn in 1978-1980. Stored sera of the participants with no history of coeliac disease or any malignancy were tested for immunoglobulin A (IgA) class tissue transglutaminase antibodies (Eu-tTG) in 2001. Positive sera were further analysed by another tissue transglutaminase antibody test (Celikey tTG) and for endomysial antibodies (EMAs). Malignant diseases were extracted from the nationwide database and antibody-positive cases were compared with negative cases during a follow-up of nearly 20 years
    • the study authors concluded that prognosis of adults with unrecognised coeliac disease with positive coeliac disease antibody status is good as regards the overall risk of malignancies (2)


Last reviewed 08/2019