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Should We Look for Celiac Disease among all Patients with Liver Function Test Abnormalities?

Mohammad Hassan Emami1, Marzieh Hashemi, Soheila Kouhestani

  • 1Department of Gastroenterology and Hepatology, Isfahan University of Medical Sciences, Isfahan, Iran.

International Journal of Preventive Medicine
|March 27, 2012
PubMed

Insights

Celiac disease (CD) affects 4.4% of patients with abnormal liver function tests (LFT). Early screening with IgA anti-tissue transglutaminase (t-TG) antibody tests is recommended for diagnosing CD in these individuals.

Area of Science:

  • Gastroenterology
  • Hepatology
  • Immunology

Background:

  • Celiac disease (CD) is linked to abnormal liver function tests (LFTs) in up to 10% of patients.
  • Limited data exists on CD prevalence in patients with abnormal LFTs in Iran.

Purpose of the Study:

  • To determine the prevalence of celiac disease (CD) in patients presenting with unexplained abnormal liver function tests (LFTs).

Main Methods:

  • IgA anti-tissue transglutaminase (t-TG) antibody testing (ELISA) was performed on patients with abnormal LFTs.
  • Seropositive patients underwent endoscopy and duodenal biopsy, classified using the Marsh criteria.
  • CD diagnosis required seropositivity, Marsh I or higher histology, and positive response to a gluten-free diet (GFD).

Main Results:

  • Out of 224 patients, 10 (4.4%) were seropositive for CD.
  • Six patients (2.7%) had Marsh I or higher on biopsy and responded well to a GFD.
  • Prevalence was 10.7% in hypertransaminasemia, 3.4% in autoimmune hepatitis, and 5.3% in cryptogenic cirrhosis.

Conclusions:

  • Routine serological screening for CD using IgA anti-tTG antibody tests is recommended for patients with abnormal LFTs.
  • Screening is particularly important for patients with chronic liver diseases like hypertransaminasemia, autoimmune hepatitis, and cryptogenic cirrhosis.
Abstract

Keywords:
Autoimmune hepatitisceliac diseasehypertransaminasemialiver diseaseliver transplant

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