Anti tissue transglutaminase antibodies as predictors of silent coeliac disease in patients with hypertransaminasaemia of unknown origin

Volta, Umberto; Granito, Alessandro; Franceschi, Lucia De; Petrolini, N.; Bianchi, Francesco

doi:10.1016/s1590-8658(01)80014-1

Cited by 58 publications

(42 citation statements)

References 21 publications

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“…16 The increased intestinal permeability seen in the context of CD may facilitate the entry of toxins, antigens, and inflammatory substances (cytokines and/or autoantibodies) to the portal circulation, and these mediators may have a role in the liver involvement seen in patients with CD. 6,9,17,18 Autoantibodies directed against the so-called celiac antigen [tissue transglutaminase (tTG)] are present in the liver and other extraintestinal tissues in CD, raising the possibility of a pathogenic role for the humoral-mediated immune responses in the liver injury observed in CD. 19 However, the specific role of these autoantibodies and the source and biologic effects of the other proposed mediators for liver injury in CD remain to be demonstrated (Fig.…”

Section: Pathogenesismentioning

confidence: 99%

The liver in celiac disease

2007

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Celiac disease is a common (1% prevalence) chronic immune-mediated disorder of the small intestine induced by dietary wheat, barley, and rye. Several hepatic disorders have been described in association with celiac disease. Isolated hypertransaminasemia with nonspecific histologic changes in a liver biopsy is the commonest hepatic presentation of celiac disease. A gluten-free diet normalizes liver enzymes and histologic changes in most patients. Moreover, celiac disease can coexist with autoimmune liver disorders such as autoimmune hepatitis, primary biliary cirrhosis, and primary sclerosing cholangitis. Celiac disease has increasingly been reported with a variety of other liver diseases. Thus, the hepatologist needs to consider celiac disease in the differential of abnormal liver blood tests and to be aware of the clinical implications of this frequent disease in patients with liver disorders. The possible mechanisms of liver injury and those common factors that explain the association of celiac disease with liver disorders are discussed. The aims of this article are (1) to review the spectrum and pathogenesis of liver injury related to celiac disease and (2) to provide direction to those caring for patients with chronic liver diseases regarding the detection and effective treatment of celiac disease. (HEPATOLOGY 2007;46:1650-1658

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Section: Pathogenesismentioning

confidence: 99%

The liver in celiac disease

2007

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“…Our finding is inconsistent with the previously reported studies. The most possible explanation for the inconsistence might the different criteria of subject selection in different studies (4,7,(23)(24)(25), since the subjects recruited for the evaluation of the relationship between CD and raised AST/ALT were classified as having unexplained elevated transaminase after the exclusion of every known cause of raised transaminase levels, e.g., alcohol or drug use, viral hepatitis, metabolic hepatic disease, and autoimmune liver diseases (4,(23)(24)(25). Only a study conducted in Iran studied the necessity of routine screening for CD in patients with abnormal liver function tests irrespective of the reason for abnormal liver function tests (7), and 6 patients were diagnosed with CD among 224 patients with abnormal liver function.…”

Section: Discussionmentioning

confidence: 99%

Serologic testing for celiac disease in young people with elevated transaminases

Yuan¹,

Gao²,

Yao

et al. 2015

Turk J Med Sci

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Background/aim: A cryptogenic elevation of transaminases is the most common hepatic manifestation in celiac disease (CD). In adult patients and pediatric patients with cryptogenic hypertransaminasemia, the prevalence of CD was 4% and 12%, respectively. However, there are no related data from China in this regard. We aimed to investigate the status of CD in young Chinese patients with elevated transaminases.Materials and methods: A total of 125 patients with elevated transaminases and 125 healthy individuals as controls with matched age and sex were involved in the study. Serum markers of hepatitis B were determined in patients with elevated transaminases. All subjects were screened for CD by testing serum IgA antitissue transglutaminase antibodies (anti-tTG IgA), and total serum IgA was determined in order to rule out IgA deficiency.Results: None of the subjects were seropositive to IgA anti-tTG antibodies. No association between CD and elevated transaminases was found. Hepatitis B viral infections were one of the main causes of raised transaminases. Conclusion:Before the exclusion of every known cause of raised transaminase levels, routine serological screening for CD should not be recommended for patients who only present elevated transaminases.

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“…Este aumento de la permeabilidad intestinal puede conducir a la absorción aumentada de toxinas o antígenos en la sangre portal, y esto puede conducir a la lesión hepática observada en estos individuos (35). Además, el tTG está presente en el hígado y en otros tejidos además de la membrana basal intestinal, lo cual sugiere la posibilidad de un rol patológico de la inmunidad humoral (anti-tTG) en la lesión hepática observada en los pacientes con enfermedad celíaca (36).…”

Section: Conflicto De Interesesunclassified

El efecto de la dieta libre de gluten en la alanina- aminotransferasa (ALT) en pacientes celíacos

Hatanaka

Silva

Dantas-Corrêa

et al. 2016

Rev. Colomb. Gastroenterol.

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El efecto de la dieta libre de gluten en la alaninaaminotransferasa (ALT) en pacientes celíacosThe effect of a gluten-free diet on alanine aminotransferase (ALT) in celiac patients ResumenIntroducción: la enfermedad celíaca es una enfermedad autoinmune provocada por la ingestión de gluten que afecta aproximadamente al 0,5%-1% de la población mundial. Las señales extraintestinales incluyen elevados niveles de alanina-aminotransferasa (ALT). Objetivo: evaluar los efectos de una dieta libre de gluten en los niveles ALT en pacientes con enfermedad celíaca. Métodos: este estudio transversal se llevó a cabo en la clínica ambulatoria de gastroenterología de un hospital universitario. Resultados: se incluyeron veintiséis pacientes con enfermedad celíaca con edad de 34,1 ± 11,4 años; 15,4% fueron hombres. Los sujetos del estudio tenían un nivel promedio de ALT de 54,6 ± 36,3 (mediana 40,5) U/L. Hubo una mayor proporción de individuos con hepatitis B en el grupo con ALT ≥50 U/L en comparación con sujetos con ALT <50 U/L. Entre los pacientes evaluados después del tratamiento con dieta libre de gluten se observó una reducción significativa de los valores de ALT (36,0 versus 31,0 U/l; p= 0,008). Conclusión: el treinta y cinco por ciento de los pacientes con enfermedad celíaca tenía ALT por encima del tercil superior. Se encontraron niveles más altos de ALT en pacientes con hepatitis viral B y en aquéllos que no se adhirieron a la dieta. Hubo una reducción de aminotransferasas como resultado de una dieta libre de gluten. Palabras claveTransaminasas, enfermedad celíaca, alanina-transaminasa, aminotransferasas aspartato, dieta, libre de gluten. AbstractIntroduction: Celiac disease is an autoimmune disease triggered by ingestion of gluten. It affects approximately 0.5% to 1% of the world population. Extra intestinal manifestations include elevated alanine aminotransferase (ALT) levels. Objective: The objective of this study was to evaluate the effects of a gluten-free diet on ALT levels in patients with celiac disease. Methods: This cross-sectional study was conducted in the gastroenterology outpatient clinic of a university hospital. Results: Twenty-six patients with celiac disease were included. Average patient age was 34.1 ± 11.4 years, and 15.4% of the patients were men. Study subjects had a mean ALT level of 54.6 ± 36.3 U/L (median 40.5). There was a higher proportion of individuals with hepatitis B in the group with ALT ≥ 50 U/L than in the group of subjects with ALT < 50 U/L. Among patients tested after treatment with a gluten-free diet, we observed a significant reduction in ALT values (36.0 vs. 31.0 U/L; P = 0.008). Conclusion: Thirty-five percent of celiac disease patients had ALT levels above the upper tertile. Higher ALT levels were found in patients with viral hepatitis B and in those who do not adhere to the diet. There was a reduction of aminotransferases with a gluten-free diet.

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Anti tissue transglutaminase antibodies as predictors of silent coeliac disease in patients with hypertransaminasaemia of unknown origin

Cited by 58 publications

References 21 publications

The liver in celiac disease

The liver in celiac disease

Serologic testing for celiac disease in young people with elevated transaminases

El efecto de la dieta libre de gluten en la alanina- aminotransferasa (ALT) en pacientes celíacos

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