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Chronic Hepatitis Due to Gluten Enteropathy - a Case Report
Irina I Ivanova1,2, Denitsa Y Dukova1,2, Pavlina G Boikova1,2
1Department of Internal Medicine, Prof. Paraskev Stoyanov Medical University, Varna, Bulgaria
Folia Medica
|July 14, 2017
Summary
Celiac disease can present with diverse symptoms, including liver issues and anemia. Early serologic screening for tissue transglutaminase antibodies is crucial for diagnosing this immune-mediated enteropathy.
Area of Science:
- Gastroenterology
- Immunology
- Hepatology
Background:
- Celiac disease is an immune-mediated enteropathy triggered by gluten in genetically susceptible individuals.
- It primarily affects the small intestine but can have systemic manifestations.
Observation:
- A 45-year-old woman presented with severe iron-deficient anemia and elevated liver enzymes.
- Endoscopy revealed duodenal changes, esophageal varices, and portal hypertensive gastropathy.
- Duodenal biopsy confirmed celiac disease with total villous atrophy and lymphocytic infiltrate.
Findings:
- Serology confirmed celiac disease with high-titer IgA and IgG antibodies to tissue transglutaminase.
- Liver biopsy showed chronic hepatitis without significant fibrosis.
- The patient's poor dietary compliance hindered treatment response.
Implications:
- Celiac disease presents with varied clinical symptoms, extending beyond gastrointestinal tract.
- Serologic screening for tissue transglutaminase antibodies is vital in diagnosing chronic liver disease.
- Highlights the importance of considering celiac disease in unexplained liver enzyme elevations and anemia.
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