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Coeliac disease hidden by cryptogenic hypertransaminasaemia
U Volta1, L De Franceschi, F Lari
1Department of Internal Medicine Cardioangiology, Hepatology, University of Bologna, Policlinic S Orsola-Malpighi, Italy.
Lancet (London, England)
|November 4, 1998
Summary
About 9% of patients with unexplained high transaminases have symptom-free coeliac disease. Antibody screening for coeliac disease (using endomysium and gliadin antibodies) is recommended for these individuals.
Area of Science:
- Gastroenterology
- Hepatology
- Immunology
Background:
- Hypertransaminasaemia of unknown origin can be an indicator of coeliac disease.
- Elevated transaminase levels are observed in approximately half of coeliac disease patients on a gluten-containing diet.
Purpose of the Study:
- To determine the prevalence of coeliac disease in patients presenting with cryptogenic hypertransaminasaemia.
Main Methods:
- 55 patients with cryptogenic hypertransaminasaemia were tested for IgA endomysial and IgA/IgG gliadin antibodies.
- Duodenal biopsies were performed on antibody-positive patients.
Main Results:
- Five patients tested positive for both IgA endomysial and IgG gliadin antibodies.
- Duodenal biopsies confirmed subtotal villous atrophy (coeliac disease) in these five patients.
- Following a gluten-free diet, transaminase levels normalized in four coeliac disease patients within six months.
Conclusions:
- Approximately 9% of patients with cryptogenic hypertransaminasaemia have asymptomatic coeliac disease.
- Antibody screening for coeliac disease (endomysial and gliadin antibodies) should be considered in patients with unexplained hypertransaminasaemia.