[Liver involvement in celiac disease in children]

Area of Science:

• Pediatric Gastroenterology
• Hepatology
• Autoimmune Diseases

Background:

• Celiac disease (CD) is an autoimmune disorder triggered by gluten, often presenting with diverse symptoms, including liver involvement.
• Atypical CD presentations can complicate diagnosis, especially in pediatric cases with unexplained liver dysfunction.

Purpose of the Study:

• To investigate liver manifestations in children diagnosed with CD.
• To evaluate the impact of a gluten-free diet (GFD) on liver function in these patients.
• To highlight the importance of immunological screening for CD in pediatric liver disease of unknown etiology.

Main Methods:

• A cohort of 120 children diagnosed with CD between 2007-2010 was studied.
• Liver function tests, viral hepatitis markers, and autoimmune hepatitis markers were assessed.
• Patients received GFD, hepatoprotective agents, and specific antivirals; transaminase levels were monitored.

Main Results:

• 10.14% of CD patients exhibited altered liver function at diagnosis, primarily elevated transaminases (57.14% of those with altered function).
• Hepatitis B surface antigen (HBsAg) was positive in 33.33% of cases.
• Four percent of patients with cryptogenetic hepatitis had undiagnosed CD, emphasizing the need for serological screening (AGA, AEA, ATGA).

Conclusions:

• CD should be considered and ruled out in pediatric patients presenting with liver disease of unknown origin before labeling it "cryptogenetic."
• Elevated transaminases without viral markers necessitate CD screening.
• Early CD diagnosis through serological testing is vital for managing associated liver dysfunction.