Liver involvement in pediatric celiac disease

Area of Science:

• Gastroenterology
• Hepatology
• Pediatrics

Background:

• Celiac disease (CD) is an intestinal inflammatory disorder affecting genetically susceptible individuals upon gluten exposure.
• It is a prevalent chronic condition, impacting approximately 1% of the population in Europe and North America.
• While primarily affecting the gut, CD can manifest with varied clinical presentations, including extraintestinal manifestations like liver involvement.

Purpose of the Study:

• To review the clinical presentations of liver injury associated with celiac disease.
• To explore the potential mechanisms underlying CD-related hepatic dysfunction.
• To identify strategies for diagnosing and treating these liver disorders in children.

Main Methods:

• Literature review of clinical presentations of celiac disease-related liver injury.
• Analysis of proposed mechanisms for CD-associated hepatic manifestations.
• Synthesis of diagnostic and therapeutic approaches for pediatric cases.

Main Results:

• Hepatic dysfunction in CD ranges from asymptomatic elevations in liver enzymes to chronic liver disease.
• Nonspecific reactive hepatitis and cryptogenic liver disorders are observed in some CD patients.
• The review consolidates information on the spectrum of liver involvement in CD.

Conclusions:

• Celiac disease can present with diverse hepatic manifestations, extending beyond gastrointestinal symptoms.
• Understanding the mechanisms of CD-related liver injury is crucial for effective management.
• Early diagnosis and appropriate treatment strategies are essential for improving outcomes in children with CD-associated liver disease.