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Prevalence of coeliac disease in unexplained chronic hypertransaminasemia
F Múgica1, A Castiella, P Otazua
1Gastroenterology Department, Hospital de Guipúzcoa, Guipúzcoa, Spain. arra@euskalnet.net
Insights
This study found that 1.4% of patients with unexplained chronic hypertransaminasemia have coeliac disease. Screening for coeliac disease should be a lower priority in this patient group in our region.
Area of Science:
- Gastroenterology
- Hepatology
- Immunology
Background:
- Unexplained chronic hypertransaminasemia is a common clinical finding.
- Coeliac disease can present with elevated liver enzymes.
- Differential diagnosis of hypertransaminasemia is extensive.
Purpose of the Study:
- To determine the prevalence of coeliac disease in patients with unexplained chronic hypertransaminasemia.
- To assess the utility of coeliac disease screening in this population.
Main Methods:
- Prospective study of 147 patients with chronic hypertransaminasemia.
- Exclusion of other liver disease causes.
- Serological testing for IgA to gliadin and endomysium antibodies.
- Intestinal biopsy for positive antibody cases.
Main Results:
- One patient positive for both antibodies; three positive for IgA to gliadin only.
- Duodenal biopsies showed normal, subtotal, or total villous atrophy.
- Overall prevalence of coeliac disease was 1.4%.
Conclusions:
- Coeliac disease prevalence is 1.4% in unexplained chronic hypertransaminasemia.
- Coeliac disease screening is a lower priority in this patient group in the studied region.
Objective:
To determine the prevalence of coeliac disease amongst the population with unexplained chronic hypertransaminasemia in our region.
Patients And Methods:
A prospective study was carried out on 147 consecutive patients with chronic hypertransaminasemia, having previously discarded alcoholic cause, hepatotoxic drugs, B, C and Delta viral infections, autoimmune hepatitis, primary biliary cirrhosis, Jemochromatosis, alfal-antitrypsin deficiency, Wilson's disease, congestive liver and illicit drug use. Serum Ig A to gliadin and endomysium antibodies were determined. Intestinal biopsy was carried out in cases those positive for one or both antibodies.
Results:
One patient was positive for both IgA to gliadin and to endonisyum antibodies, whereas another three patients were positive to IgA to gliadin only. A duodenal biopsy proved normal in two, a total villous atrophy in one and subtotal atrophy in other.
Conclusions:
1. The prevalence of coeliac disease amongst the population with unexplained chronic hypertransaminasemia in our region is 1.4%. 2. In our region, screening for coeliac disease in unexplained chronic hypransaminasemia should take a secondary place.