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Liver involvement in celiac disease.

Giuseppe Maggiore1, Silvia Caprai

  • 1Department of Reproductive Medicine and Child Development University of Pisa, Gastroenterology and Liver Unit and IsMeTT, University of Pittsburgh Medical Center, Palermo, Italy. g.maggiore@clp.med.unipi.it

Indian Journal of Pediatrics
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PubMed
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Celiac disease (CD) can manifest as various liver disorders, from mild damage reversible with a gluten-free diet to severe liver failure. Early screening for CD in liver patients and vice versa is recommended.

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Area of Science:

  • Hepatology
  • Gastroenterology
  • Immunology

Background:

  • Celiac disease (CD) is associated with cryptogenic liver disorders in 5-10% of patients with elevated aminotransferases.
  • Liver injuries linked to CD range from mild, reversible damage to chronic inflammatory conditions and severe liver failure.

Purpose of the Study:

  • To explore the spectrum of liver manifestations in celiac disease.
  • To emphasize the importance of cross-checking for celiac disease in patients with unexplained liver disorders and vice versa.

Main Methods:

  • Review of literature on celiac disease and liver injury.
  • Clinical case analysis of patients with celiac disease and liver manifestations.

Main Results:

  • Celiac disease can present as mild liver damage, autoimmune liver diseases (autoimmune hepatitis, PSC, PBC), or severe liver failure.
  • Liver damage in CD is influenced by genetic predisposition and gluten exposure duration.
  • Mild liver damage is often reversible with a gluten-free diet, while autoimmune conditions may require immunosuppression.

Conclusions:

  • A gluten-free diet can reverse mild liver damage in celiac disease.
  • Autoimmune liver diseases in CD may necessitate immunosuppressive therapy.
  • Screening for celiac disease in cryptogenic liver disorders, including end-stage liver failure, is crucial for accurate diagnosis and management.