The Indian Journal of Pediatrics

, Volume 73, Issue 9, pp 809–811 | Cite as

Liver involvement in celiac disease

Symposium on Hepatology and Gastroenterology—II

Abstract

Celiac disease may present as a cryptogenic liver disorder being found in 5–10% of patients with a persistent and cryptogenetic elevation of serum aminotransferase activity. In fact, a wide spectrum of liver injuries in children and adults may be related to CD and in particular: (1) a mild parenchymal damage characterised by absence of any clinical sign or symptom suggesting a chronic liver disease and by non-specific histological changes reversible on a gluten-free diet; (2) a chronic inflammatory liver injury of autoimmune mechanism, including autoimmune hepatitis, primary sclerosing cholangitis and primary biliary cirrhosis, that may lead to fibrosis and cirrhosis, generally unaffected by gluten withdrawal and necessitating an immunosuppressive treatment; (3) a severe liver failure potentially treatable by a gluten-free diet. Such different types of liver injuries may represent a spectrum of a same disorder where individual factors, such as genetic predisposition, precocity and duration of exposure to gluten may influence the reversibility of liver damage. A rigorous cross-checking for a asymptomatic liver damage in CD individuals and conversely, for CD in any cryptogenic liver disorder including end-stage liver failure is recommended.

Key words

Celiac disease Autoimmune liver disease Acute liver failure Cryptogenic liver damage 

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References

  1. 1.
    Pollock DJ. The liver in coeliac disease.Histopathology 1977; 1: 421–430.PubMedCrossRefGoogle Scholar
  2. 2.
    Duggan JM, Duggan AE. Systematic review: The liver in celiac disease.Aliment Pharmacol Ther 2005; 21: 515–518.PubMedCrossRefGoogle Scholar
  3. 3.
    Cassagnou M, Boruchowicz A, Guillemot Fet al. Hepatic steatosis revealing celiac disease: a case complicated by transitory liver failure.Am J Gastroenterol 1996; 91: 1291–1292.PubMedGoogle Scholar
  4. 4.
    Austin A, Campbell E, Lane P, Elias E. Nodular regenerative hyperplasia of the liver and coeliac disease: potential role of IgA anti-cardiolipin antibody.Gut 2004; 53: 1032–1034PubMedCrossRefGoogle Scholar
  5. 5.
    Hagander B, Brandt L, Sjolund K, Berg NO, Nordén Å Stenstam M. Hepatic injury in adult coeliac disease.Lancet 1977; 2: 270–272.PubMedCrossRefGoogle Scholar
  6. 6.
    Bonamico M, Pitzalis G. Culasso Fet al. A. Il danno epatico nella malattia celiaca del bambino.Minerva Pediatr 1986; 38: 959–962.PubMedGoogle Scholar
  7. 7.
    Leonardi S, Bottaro G, Patané R, Musumeci S. Hypetransaminasemia as the first symptom in infant celiac disease.J Pediatr Gastroenterol Nutr 1990; 11: 404–406.PubMedGoogle Scholar
  8. 8.
    Maggiore G, De Giacomo C, Scotta MS, Sessa F. Celiac disease presenting as chronic hepatitis in girl.J Pediatr Gastroenterol Nutr 1986; 5: 501–503.PubMedCrossRefGoogle Scholar
  9. 9.
    Vajro P, Fontanella A, Mayer Met al. Elevated Serum minotransferases activity as an early manifestation of glutensensitive enteropathy.J Pediatr 1993; 122: 416–419.PubMedCrossRefGoogle Scholar
  10. 10.
    Volta U, De Franceschi L, Lari F, Molinaro N, Zoli M, Bianchi FB. Coeliac disease hidden by cryptogenic hypertransaminasemia.Lancet 1998; 352: 26–29.PubMedCrossRefGoogle Scholar
  11. 11.
    Bardella MT, Vecchi M, Conte Det al. Chronic unexplained hypertransaminasemia may be caused by occult celiac disease.Hepatology 1999; 29: 654–657.PubMedCrossRefGoogle Scholar
  12. 12.
    Maggiore G, Caprai S. The Liver in celiac disease.J Pediatr Gastroenterol Nutr 2003; 37: 117–119.PubMedCrossRefGoogle Scholar
  13. 13.
    Demir H, Yüce A, Caglar Met al. Cirrhosis in children with celiac disease.J Clin Gastroenterol 2005; 39: 630–633.PubMedCrossRefGoogle Scholar
  14. 14.
    Lindgren S, Sjoberg K, Eriksson S. Unsuspected celiac disease in chronic cryptogenic liver disease.Scand J Gastroenterol 1994; 29: 661–664.PubMedCrossRefGoogle Scholar
  15. 15.
    Volta U, De Franceschi L, Molinaro Net al. Frequency and significance of anti-gliadin and anti-endomisial antibodies in autoimmune hepatitis.Dig Dis Sci 1998; 43: 2190–2195.PubMedCrossRefGoogle Scholar
  16. 16.
    Francavilla R, Castellaneta SP, Davis T, Hadzic N, Mieli-Vergani G. Coeliac disease in children with autoimmune hepatitis.Dig Liver Dis 2001; 33: 624 (abstract)Google Scholar
  17. 17.
    Ventura A, Magazzu' G, Greco L. Duration of exposure to gluten and risk for autoimmune disorders in patients with celiac disease.Gastroenterology 1999; 117: 297–303.PubMedCrossRefGoogle Scholar
  18. 18.
    Lawson A, West J, Aithal GP, Logan RF. Autoimmune cholestatic liver disease in people with celiac disease: a population-based study of their association.Aliment Pharmacol Ther 2005; 21: 401–405.PubMedCrossRefGoogle Scholar
  19. 19.
    Jacobsen MB, Fausa O, Elgjo K, Schrumpf E. Hepatic lesions in adult coeliac disease.Scand J Gastroenterol 1990; 25: 656–662.PubMedCrossRefGoogle Scholar
  20. 20.
    Davison S. Coeliac disease and liver dysfunction.Arch Dis Child 2002; 87: 293–296.PubMedCrossRefGoogle Scholar
  21. 21.
    Korponay-Szabo IR, Halttunen T, Szalai Zet al. In vivo targeting of intestinal and extraintestinal transglutaminase 2 by coeliac autoantibodies.Gut 2004; 53: 641–648.PubMedCrossRefGoogle Scholar
  22. 22.
    Stevens FM, McLoughlin RM. Is coeliac disease a potentially treatable cause of liver failure?Eur J Gastroenterol Hepatol 2005; 17: 1015–1017.PubMedCrossRefGoogle Scholar
  23. 23.
    Kaukinen K, Halme L, Collin Pet al. K. Coeliac disease in patients with severe liver disease: gluten free diet may reverse hepatic failure.Gastroenterology 2002; 122: 881–888.PubMedCrossRefGoogle Scholar
  24. 24.
    Ojetti V, Fini I, Zileri Dal Verme L, Migneco A, Pola P, Gasbarrini A. Acute cryptogenic liver failure in an untreated coeliac patient: a case report.Eur J Gastroenterol Hepatol 2005; 17: 1119–1121.PubMedCrossRefGoogle Scholar
  25. 25.
    Pavone P, Guttadauria S, Leonardi Set al. Liver transplantation in a child with celiac disease.J Gastroenterol Hepatol 2005; 20: 956–960.PubMedCrossRefGoogle Scholar
  26. 26.
    Villalta D, Crovatto M, Stella S, Tonutti E, Tozzoli R, Bizzarro N. False positive reactions for IgA and IgG anti-tissue transglutaminase antibodies in liver cirrhosis are common and method-dependent.Clin Chim Acta 2005; 356: 102–109.PubMedCrossRefGoogle Scholar
  27. 27.
    Lo Iacono O, Petta S, Venezia Get al. Anti-tissue transglutaminase antibodies in patients with abnormal liver tests: is it always celiac disease?Am J Gastroenterol 2005; 100: 2472–2477.PubMedCrossRefGoogle Scholar

Copyright information

© Dr. K C Chaudhuri Foundation 2006

Authors and Affiliations

  1. 1.Department of Reproductive Medicine and Child DevelopmentUniversity of PisaPisaItaly
  2. 2.Gastroenterology and Liver Unit and IsMeTTUniversity of Pittsburgh Medical CenterPalermoItaly
  3. 3.Dipartimento di Medicina della Procreazione e della Età EvolutivaUniversitá di PisaPisaItaly

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