Hepatobiliary disorders in celiac disease: an update

Area of Science:

• Hepatology
• Gastroenterology
• Immunology

Background:

• Celiac disease is an autoimmune disorder triggered by gluten ingestion.
• Hepatobiliary abnormalities are increasingly recognized as potential complications of celiac disease.
• Many patients with celiac disease lack typical gastrointestinal symptoms, complicating diagnosis.

Purpose of the Study:

• To review and summarize the spectrum of hepatobiliary abnormalities associated with celiac disease.
• To highlight the importance of early diagnosis and management of celiac disease to prevent liver complications.
• To discuss the utility of specific antibody tests in screening for celiac disease.

Main Methods:

• Literature review of recent studies on celiac disease and hepatobiliary manifestations.
• Summary of reported liver enzyme abnormalities and specific liver diseases in celiac patients.
• Evaluation of diagnostic approaches, including serum antibody testing.

Main Results:

• A wide range of liver issues, from elevated enzymes to autoimmune and cholestatic liver diseases, can occur in celiac disease.
• Most liver enzyme abnormalities improve with a gluten-free diet.
• Rare but serious hepatic complications, such as T-cell lymphoma, can be associated with celiac disease.

Conclusions:

• Hepatobiliary abnormalities are a significant, though often overlooked, complication of celiac disease.
• A high index of suspicion and early diagnosis using serological markers (IgG DGP and IgA tTG) are essential.
• Prompt diagnosis and adherence to a gluten-free diet can lead to resolution of liver enzyme abnormalities and prevent severe outcomes.