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Recognition of Epidermal Transglutaminase by IgA and Tissue Transglutaminase 2 Antibodies in a Rare Case of Rhesus Dermatitis
Published on: December 15, 2011
Meta-analysis: Coeliac disease and hypertransaminasaemia
A Sainsbury1, D S Sanders, A C Ford
1Leeds Gastroenterology Institute, Leeds General Infirmary, Great George Street, Leeds, UK.
Alimentary Pharmacology & Therapeutics
|May 7, 2011
Summary
Undetected coeliac disease (an autoimmune disorder) is a potential cause of unexplained high liver enzymes in 3-4% of adults. Over 20% of newly diagnosed coeliac disease patients have elevated transaminases, which improve with a gluten-free diet.
Area of Science:
- Gastroenterology
- Hepatology
- Immunology
Background:
- Conflicting evidence exists regarding the association between coeliac disease and elevated serum transaminases (liver enzymes).
- Cryptogenic hypertransaminasaemia, or unexplained elevated liver enzymes, may be linked to underlying coeliac disease.
Purpose of the Study:
- To systematically review and meta-analyze the prevalence of coeliac disease in adults with cryptogenic hypertransaminasaemia.
- To determine the prevalence of hypertransaminasaemia in patients with newly diagnosed coeliac disease.
Main Methods:
- A systematic literature search of MEDLINE and EMBASE up to August 2010.
- Inclusion of case series and case-control studies involving adults with cryptogenic hypertransaminasaemia or newly diagnosed coeliac disease.
- Calculation of pooled prevalence rates for coeliac disease and hypertransaminasaemia using 95% confidence intervals.
Main Results:
- The pooled prevalence of positive coeliac serology was 6% (95% CI 3% to 10%) and biopsy-proven coeliac disease was 4% (95% CI 1% to 7%) in individuals with cryptogenic hypertransaminasaemia.
- The pooled prevalence of abnormal serum transaminases in newly diagnosed coeliac disease patients was 27% (95% CI 13% to 44%).
- Gluten exclusion normalized transaminase levels in 63% to 90% of coeliac disease patients within one year.
Conclusions:
- Undetected coeliac disease is a significant potential cause (3-4%) of cryptogenic hypertransaminasaemia.
- Elevated serum transaminases are common (over 20%) in newly diagnosed coeliac disease and typically resolve with a gluten-free diet.
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