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High Levels of Antibodies at Celiac Diagnosis Makes Hepatitis More Likely


Photo: CC--Michael Carian

Celiac.com 09/19/2016 - At the time of diagnosis, some celiac patients suffer also from what is called celiac hepatitis, which is liver damage in patients with celiac disease that resolves after a gluten-free diet.

A team of researchers recently set out to evaluate predictive factors of celiac hepatitis at the celiac disease diagnosis stage. To do so, they conducted a retrospective study that included 46 adult patients with clinically diagnosed celiac disease.

The research team included Andreia Albuquerque, Susana Rodriguesa, and Guilherme Macedoa of the Department of Gastroenterology at Centro Hospitalar São João, in Porto, Portugal.

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Of the 46 patients, eighty-seven percent were women, with an average age of 33 ± 11 years, 87% showed Marsh 3, and 21 patients (46%) had celiac hepatitis. At the time of diagnosis, these patients had average Immunoglobulin A anti-tissue transglutaminase antibody (TTG-IgA) levels of 208.0 U/ml (p25–p75: 89–1316 U/ml), a mean aspartate aminotransferase of 42 ± 24 U/L, alanine aminotransferase 50 ± 28 U/L, alkaline phosphatase 111 ± 64 U/L. One year after diagnosis, the median average TTG-IgA was 9U/ml (p25–p75: 4.5–30.5 U/ml) and one-third of the patients had normal values.

At diagnosis, patients without celiac hepatitis had an average TTG-IgA of 77U/ml (p25–p75: 24–288 U/ml), average aspartate aminotransferase of 23 ± 4 U/L, alanine aminotransferase 20 ± 6 U/L, alkaline phosphatase 69 ± 17 U/L. One year after diagnosis, median TTG-IgA was 6 U/ml (p25–p75: 3–19 U/ml) and nearly half of the patients showed normal values.

At diagnosis, patients with celiac hepatitis had higher values of TTG-IgA (p = 0.007). Also, at diagnosis, there was a statistically significant positive correlation between TTG-IgA and alanine aminotransferase (r = 0.324, p = 0.028). For patients with a TTG-IgA level higher than 310 U/ml (OR = 4.8, 95%CI = 1.213–18.781, p = 0.025), the risk of having celiac hepatitis was nearly 5-times higher. From this, the team concludes that higher TTG-IgA levels can help predict celiac hepatitis in adult patients with celiac disease at diagnosis.

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I have celiac and eosinaphalic esophagitis. I was put on a steroid inhaler recently. I use it like an inhaler but swallow the air instead of breathing it in. You may want to look into EOE and it's relationship to celiac. Just a thought. My swallowing and celiac seem to be related.

You have eat gluten every single day until after testing. And the celiac blood test is supposed to be done as well.

If I was the big guy, there's no way I would have to wait 3 and a half weeks for a test lol. My GI doc never recommended the antibody test. He said doing it with the scope was the only sure way to know. Does anybody know if I should eat a little gluten the day before my test to see if I will get an accurate enough test? Or will it not matter, once the damage is done it's done?

Unfortunately you need to keep eating gluten until all celiac testing is complete.

That explains EVERYTHING. I had Aetna PPO about 4 years ago, and it was horrible. Absolutely horrible, and expensive. They jacked up the price the year Obamacare came out, from $550 a month (family) to $725 a month and I got stuck paying it for a year. I dropped them like a rock when open season came around. They are a greedy and worthless insurance company.