Celiac Disease and Elevated Liver Enzymes: A Review

Area of Science:

• Gastroenterology
• Hepatology
• Immunology

Background:

• Elevated aminotransferases are frequently observed in celiac disease patients.
• This elevation is associated with both cryptogenic and autoimmune liver disorders.
• Understanding the link between celiac disease and liver dysfunction is crucial for patient management.

Purpose of the Study:

• To review the mechanisms of elevated aminotransferases in celiac disease.
• To discuss clinical manifestations and treatment responses.
• To highlight the importance of dietary intervention and further workup.

Main Methods:

• Literature review of studies investigating celiac disease and liver dysfunction.
• Analysis of clinical data on aminotransferase levels, histology, and serology.
• Examination of proposed mechanisms, including intestinal permeability.

Main Results:

• Celiac patients with cryptogenic liver disease showed normalized aminotransferases, improved histology, and serology after 6-12 months on a gluten-free diet.
• Simultaneous treatment for celiac disease and autoimmune liver disease normalized elevated aminotransferases.
• Increased intestinal permeability is suggested as a mechanism for liver damage.

Conclusions:

• Routine liver enzyme checks are recommended for celiac disease patients.
• A strict gluten-free diet is an effective treatment for diet-responsive liver enzyme elevations.
• Persistent abnormalities despite dietary adherence warrant further investigation for other liver diseases.