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Should We Look for Celiac Disease among all Patients with Liver Function Test Abnormalities?
Mohammad Hassan Emami1, Marzieh Hashemi, Soheila Kouhestani
1Department of Gastroenterology and Hepatology, Isfahan University of Medical Sciences, Isfahan, Iran.
International Journal of Preventive Medicine
|March 27, 2012
Summary
Celiac disease (CD) affects 4.4% of patients with abnormal liver function tests (LFT). Early screening with IgA anti-tissue transglutaminase (t-TG) antibody tests is recommended for diagnosing CD in these individuals.
Area of Science:
- Gastroenterology
- Hepatology
- Immunology
Background:
- Celiac disease (CD) is linked to abnormal liver function tests (LFTs) in up to 10% of patients.
- Limited data exists on CD prevalence in patients with abnormal LFTs in Iran.
Purpose of the Study:
- To determine the prevalence of celiac disease (CD) in patients presenting with unexplained abnormal liver function tests (LFTs).
Main Methods:
- IgA anti-tissue transglutaminase (t-TG) antibody testing (ELISA) was performed on patients with abnormal LFTs.
- Seropositive patients underwent endoscopy and duodenal biopsy, classified using the Marsh criteria.
- CD diagnosis required seropositivity, Marsh I or higher histology, and positive response to a gluten-free diet (GFD).
Main Results:
- Out of 224 patients, 10 (4.4%) were seropositive for CD.
- Six patients (2.7%) had Marsh I or higher on biopsy and responded well to a GFD.
- Prevalence was 10.7% in hypertransaminasemia, 3.4% in autoimmune hepatitis, and 5.3% in cryptogenic cirrhosis.
Conclusions:
- Routine serological screening for CD using IgA anti-tTG antibody tests is recommended for patients with abnormal LFTs.
- Screening is particularly important for patients with chronic liver diseases like hypertransaminasemia, autoimmune hepatitis, and cryptogenic cirrhosis.
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