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Celiac disease-associated autoimmune cholangitis
Robert E Sedlack1, Thomas C Smyrk, Albert J Czaja
1Division of Gastroenterology and Hepatology, Mayo Clinic and Foundation, Rochester, Minnesota 55905, USA.
The American Journal of Gastroenterology
|December 21, 2002
Summary
Celiac disease (CD) is linked to autoimmune cholangitis. A gluten-free diet resolved symptoms in a patient with autoimmune cholangitis and CD, suggesting a direct role for CD.
Area of Science:
- Gastroenterology
- Hepatology
- Immunology
Background:
- Primary biliary cirrhosis is associated with celiac disease.
- Limited data exists on the link between celiac disease and autoimmune cholangitis (antimitochondrial antibody-negative primary biliary cirrhosis).
Observation:
- A 60-year-old woman presented with elevated liver enzymes, pruritus, and iron deficiency anemia.
- Liver biopsy suggested early primary biliary cirrhosis, but antimitochondrial antibody tests were negative.
- Further testing revealed celiac disease.
Findings:
- Initiating a gluten-free diet led to the resolution of anemia, pruritus, and liver enzyme elevations.
- This suggests celiac disease may directly contribute to the development of autoimmune cholangitis.
- Normalization of liver function was achieved without immunosuppressants.
Implications:
- Celiac disease should be considered in patients diagnosed with autoimmune cholangitis.
- A gluten-free diet may obviate the need for immunosuppressive therapy in some patients with autoimmune cholangitis.
- This case highlights a potential therapeutic approach for autoimmune cholangitis.