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Induction of Drug-Induced, Autoimmune Hepatitis in BALB/c Mice for the Study of Its Pathogenic Mechanisms
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Celiac disease-associated autoimmune hepatitis in childhood: long-term response to treatment

Silvia Nastasio1, Marco Sciveres, Silvia Riva

  • 1Department of Clinical and Experimental Medicine, Division of Pediatric Gastroenterology, University of Pisa, Pisa, Italy.

Journal of Pediatric Gastroenterology and Nutrition
|February 14, 2013
PubMed

Insights

Children with autoimmune hepatitis and celiac disease achieved sustained remission more often after treatment. A gluten-free diet may improve long-term outcomes in these patients.

Area of Science:

  • Hepatology
  • Gastroenterology
  • Immunology

Background:

  • Autoimmune liver disease (AILD) frequently coexists with celiac disease (CD).
  • Long-term treatment responses in patients with coexisting AILD and CD are not well-documented.
  • Autoimmune hepatitis (AIH) is a common form of AILD.

Purpose of the Study:

  • To investigate the clinical features of autoimmune hepatitis (AIH) in children with coexisting celiac disease (CD).
  • To analyze the long-term response to immunosuppressive therapy in pediatric patients with AIH and CD.
  • To compare treatment outcomes between AIH patients with and without CD.

Main Methods:

  • Retrospective and prospective single-center study.
  • Inclusion of 79 patients with AIH, with 15 diagnosed with CD.
  • Evaluation of immunosuppressive treatment (prednisone, azathioprine, cyclosporine) and gluten-free diet adherence.

Main Results:

  • 19% of AIH patients had CD; these patients were more often female and diagnosed earlier.
  • All 15 AIH patients with CD on a gluten-free diet achieved sustained remission.
  • Significantly higher proportion (33%) of AIH patients with CD achieved treatment-free remission compared to AIH patients without CD (8%).

Conclusions:

  • Coexistence of celiac disease in autoimmune hepatitis may lead to a higher rate of treatment-free sustained remission.
  • A gluten-free diet might have a long-term adjuvant effect in managing autoimmune hepatitis.
  • Further research is warranted to confirm the impact of gluten-free diet on AIH prognosis.
Abstract

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