- Celiac Disease Research: Associated Diseases and Disorders
- Liver Disease and Celiac Disease
- Hepatic Injury in Adult Celiac Disease
Hepatic Injury in Adult Celiac Disease
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Author: Hagander B; Berg NO;
Brandt L; Nord en A; Sj olund K; Stenstam M.
Source: Lancet, 1977 Aug 6, 2:8032, 270-2.
an attempt to determine the frequency of liver injury in adult
coeliac disease (A.C.D.) the case records of 74 consecutive
patients were examined. In 13 cases histological sections of
the liver were available and in 5 of these there were signs
of reactive hepatitis. Histological signs of distinct hepatic
injury with cirrhosis and/or chronic active hepatitis were found
in 7 other patients. In 5 of these serum-IgA was normal, whereas
16 out of 20 control patients with liver cirrhosis not associated
with A.C.D. had raised serum-IgA. Serum-aspartate-aminotransferase
and serum-alanine-aminotransferase were determined in 53 patients;
29 had raised concentrations. In 19 patients serum-aminotransferases
were repeatedly determined before and during the dietary regimen
and there was a significant reduction in enzyme concentrations
during treatment. The median concentration of serum-alkaline-phosphatase
was also reduced during treatment but not significantly. The
histological evidence of liver injury in 16% and the abnormal
liver-function tests in 39% of the patients indicate that hepatic
injury is common in A.C.D. Since liver-function tests or liver
biopsy specimens were available for only about two-thirds of
the patients, liver damage in A.C.D. may be more common than
indicated by these results. The effect of a gluten-free diet
on aminotransferase concentrations indicates that the liver
injury may be reversible and suggests that in some A.C.D. patients,
progressive liver damage may be prevented by suitable treatment.
Since A.C.D. is not always recognized, the diagnosis should
be considered in patients with liver disease of unknown aetiology.
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