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Showing results for tags 'autoimmune hepatitis'.
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Celiac.com 01/16/2025 - Celiac disease, an autoimmune condition triggered by gluten consumption, is known for its gastrointestinal and systemic impacts. Recent research indicates potential connections between celiac disease and chronic liver disease. This summary highlights findings from a large-scale Swedish study that explored whether celiac disease increases the long-term risk of chronic liver disease and major liver-related complications. Study Methods and Design The study utilized data from the Swedish ESPRESSO cohort, incorporating over 48,000 individuals diagnosed with celiac disease through intestinal biopsy between 1969 and 2017. These participants were compared to nearly 232,000 matched individuals from the general population. Researchers followed these groups until 2021 to evaluate the incidence of chronic liver disease, including conditions such as autoimmune liver disease, metabolic dysfunction-associated liver disease, alcohol-related liver disease, and viral hepatitis. Major adverse liver outcomes, such as cirrhosis, liver cancer, liver transplantation, and liver-related death, were also assessed. Elevated Risk of Chronic Liver Disease Celiac disease patients exhibited a twofold higher risk of developing chronic liver disease compared to the general population. This increased risk persisted for over 25 years after diagnosis. For every 110 individuals with celiac disease, one additional case of chronic liver disease was observed within this timeframe. Specific Liver Conditions The study found varying levels of increased risk depending on the type of liver disease: Autoimmune Liver Disease: Patients with celiac disease were nearly five times more likely to develop autoimmune liver conditions. Metabolic Dysfunction-Associated Liver Disease: This condition was 2.5 times more common in individuals with celiac disease. Alcohol-Related Liver Disease: A moderate increase in risk (1.5 times) was noted for alcohol-related liver disease. Major Liver Complications Celiac disease patients faced a 54% higher risk of major adverse liver outcomes, including liver failure, liver-related death, and liver cancer. Factors Influencing Liver Disease Risk Diagnostic Bias The elevated risk was most pronounced shortly after celiac diagnosis, potentially due to diagnostic workups that identified existing liver abnormalities. However, even after accounting for this, the risk remained elevated for decades. Genetics and Autoimmune Links The study highlighted shared genetic predispositions between celiac disease and autoimmune liver conditions, particularly involving HLA genes. Diet and Metabolism Adopting a gluten-free diet, essential for managing celiac disease, can sometimes lead to rapid weight gain or an imbalanced diet, which may increase the risk of metabolic-related liver diseases. Implications for Patients and Physicians Monitoring and Prevention While the absolute risk of chronic liver disease remains low, the findings underscore the importance of regular liver enzyme monitoring for individuals with celiac disease, especially during the early years after diagnosis. Physicians should be vigilant for signs of liver dysfunction, particularly in those with additional risk factors, such as metabolic disorders or autoimmune conditions. Patient Education Educating patients about maintaining a balanced gluten-free diet and avoiding excessive alcohol consumption could reduce liver-related risks. Patients with elevated liver enzymes may benefit from closer dietary and metabolic monitoring. Conclusion This study highlights a persistent, albeit low, increased risk of chronic liver disease in individuals with celiac disease. The findings emphasize the need for proactive monitoring and preventive measures to mitigate long-term liver-related complications. For patients with celiac disease, understanding these risks and collaborating with healthcare providers can lead to better overall management and long-term health outcomes. Read more at: thelancet.com
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Celiac.com 06/27/2023 - Some individuals with celiac disease experience liver complications such as elevated liver enzymes, liver cirrhosis, and autoimmune hepatitis. A group of researchers conducted a systematic review with meta-analyses to determine the combined prevalence of celiac disease in patients with different liver conditions. Here's what they found. The research team included Yoosuf, Shakira MD; Singh, Prashant MD; Khaitan, Ashank MBBS; Strand, Tor A. MD; Ahuja, Vineet MD, DM; and Makharia, Govind K. MD, DM, DNB. They are variously affiliated with the Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, Delhi, India; the Chettinad Hospital and Research Institute, Chennai, Tamilnadu, India; the Division of Gastroenterology, University of Michigan, Ann Arbor, Michigan, USA; the Department of Global Public Health, Innlandet Hospital Trust, Lillehammer, Norway. Medical Databases Searched for Relevant Liver and Celiac Diesase Studies They searched medical databases for relevant studies up to January 2022. Studies that performed serological tests and/or intestinal biopsy for celiac disease on patients with cryptogenic cirrhosis, all-cause cirrhosis, cryptogenic hypertransaminasemia (elevated liver enzymes), and all-cause hypertransaminasemia were included. The researchers calculated the pooled estimates of seroprevalence (presence of celiac antibodies in the blood) and the rates of biopsy-confirmed celiac disease in these four groups. Out of the many articles screened, 20 articles were included in the final analysis for cryptogenic cirrhosis, all-cause cirrhosis, and cryptogenic hypertransaminasemia. However, for all-cause hypertransaminasemia, a qualitative review of four studies was conducted due to significant differences in the studies. Patients with Cryptogenic Cirrhosis ~5% and Cryptogenic Hypertransaminasemia 6% The results showed that the pooled prevalence of biopsy-confirmed celiac disease in patients with cryptogenic cirrhosis was approximately 5%. For all-cause cirrhosis, the prevalence was less than 1%. In the case of cryptogenic hypertransaminasemia, the pooled prevalence of biopsy-confirmed celiac disease was nearly 6%. These findings suggest that approximately 1 in 20 patients with cryptogenic cirrhosis or cryptogenic hypertransaminasemia have celiac disease. Therefore, individuals with these liver conditions should be considered high-risk groups for celiac disease and may benefit from screening. Although the prevalence of celiac disease in individuals with all-cause cirrhosis is similar to the general population, it may still be worth conducting celiac screening the, because the liver damage in these cases has the potential for reversal. Read more in The American Journal of Gastroenterology 118(5):p 820-832, May 2023.
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Celiac.com 01/03/2022 - Studies looking at rates of celiac disease in people with autoimmune hepatitis (AIH) have shown wide ranging results. A team of researchers recently set out to examine the rates of celiac disease in individuals with autoimmune hepatitis. For their systematic review and meta-analysis the team used two professional librarians to conduct a search of PubMed, EMBASE, Cochrane and Web of Science Core Collection up to 7 February 2020. Search terms included 'celiac disease', 'celiac', 'transglutaminases', 'gluten', 'gliadin', 'EMA', 'TTG' and 'villous' combined with 'autoimmune', 'hepatitis', 'ANA', 'SMA' and 'LKM'. This search yielded 2,419 unique publications. A systematic review based on the PRISMA guidelines resulted in 31 articles eligible for full text review. They found fifteen relevant articles, eight of which they included in their main analysis. The team used a fixed-effect inverse variance-weighted model, and calculated heterogeneity. The team's main analysis included 567 autoimmune hepatitis patients from eight studies. Twenty three of those patients showed biopsy-verified celiac disease equivalent to Marsh III. The pooled rate of celiac disease in autoimmune hepatitis patients 3.5%, which is more than triple the 1% celiac disease rates in most general populations. When also including the fifteen studies on 1,817 people where celiac disease had been diagnosed through positive serology without biopsy, the pooled rate of celiac disease was just under 3%. The team's results show high rates of celiac disease in people with autoimmune hepatitis compared to the general population. As such, they are recommending that physicians consider celiac disease screening for patients with autoimmune hepatitis. Read more in Liver International. 2021;44(11):2693-2702. The research team included Linnea Haggård; Ida Glimberg; Benjamin Lebwohl; Rajani Sharma; Elizabeth C. Verna; Peter H. R. Green; and Jonas F. Ludvigsson. They are variously affiliated with the Department Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; the School of Medical Sciences, Örebro University, Örebro, Sweden; the Celiac Disease Center, Department of Medicine, Columbia University Medical Center, New York, NY, USA; the Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA; the Center for Liver Disease and Transplantation, Division of Digestive and Liver Diseases, Columbia University Irving Medical Center, New York, NY, USA; the Division of Digestive and Liver Diseases, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA; the Department of Pediatrics, Örebro University Hospital, Örebro University, Örebro, Sweden; and the Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, UK.
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Celiac.com 07/14/2021 - Prior efforts to determine rates of celiac disease in individuals with autoimmune hepatitis (AIH) have shown highly variable data. To get better data and develop a clearer picture of the issue, a team of researchers recently set out to assess rates of celiac disease in individuals with AIH. For their study, the team employed two professional librarians to search PubMed, EMBASE, Cochrane and Web of Science Core Collection for entries through February 7th, 2020. Their search turned up nearly 2,500 unique publications that included any of the terms “celiac disease”, “celiac”, “transglutaminases”, “gluten”, “gliadin”, “EMA”, “TTG” and “villous” combined with “autoimmune”, “hepatitis”, “ANA”, “SMA” or “LKM”. The team then conducted a systematic review based on the PRISMA guidelines. They found 31 articles eligible for full-text review, 15 of which were deemed relevant. They included eight publications in their main analysis, using a fixed-effect inverse variance-weighted model, and also determining heterogeneity. Their final analysis included 567 individuals with AIH from eight studies, where they found biopsy-verified celiac disease equivalent to Marsh III in 23 individuals, for a rate of about 4%. The pooled rate of celiac disease in AIH was 3.5%, more than triple the 1% celiac disease rates found in most general populations. When 15 other studies of 1,817 AIH patients were included, where celiac disease had been diagnosed through positive serology without biopsy, the pooled rate of celiac disease was still about 3%. This study shows that celiac disease rates are higher in individuals with AIH compared to the general population. The study team recommends that doctors consider celiac screening in patients with AIH. Read more in Liver International The research team included Linnea Haggård, Ida Glimberg, Benjamin Lebwohl, Rajani Sharma, Elizabeth C Verna, Peter HR Green, and Jonas F. Ludvigsson. They are variously affiliated with the Department Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; School of Medical Sciences, Örebro University, Örebro, Sweden; Celiac Disease Center, Department of Medicine, Columbia University Medical Center, New York, NY, USA; the Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA; the Center for Liver Disease and Transplantation, Division of Digestive and Liver Diseases, Columbia University Irving Medical Center, New York, New York, USA; the Division of Digestive and Liver Diseases, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, New York, USA; the Department of Pediatrics, Örebro University Hospital, Örebro University, Örebro, Sweden; and the Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, UK.
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