HEPATIC INJURY IN ADULT C&amp;#x152;LIAC DISEASE

Hagander, Barbro; Berg, Nils O.; Brandt, L.; Nordén, Å.; Sjölund, K.; Stenstam, M.

doi:10.1016/s0140-6736(77)90954-0

Cited by 146 publications

(80 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Indeed, hypertransaminasemia has been reported in about 40% of adults and in 54% of children with a classical presentation of CD at the time of diagnosis. [6][7][8] Conversely, CD is present in about 9% of patients with chronic unexplained hypertransaminasemia. 9,10 CD may also be associated with severe forms of liver disease.…”

Section: Liver Involvement In Celiac Diseasementioning

confidence: 99%

“…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%

“…Most patients with liver injury associated with CD have no symptoms or signs of liver disease at the time of diagnosis, although nonspecific symptoms such as malaise and fatigue are common. [6][7][8][9] The physical examination is normal in most patients. 8,9 Palmar erythema, jaundice, finger clubbing, spider angiomata, ascites, hepatomegaly, and splenomegaly have been described when patients with CD have cirrhosis.…”

Section: Clinical Manifestationsmentioning

confidence: 99%

“…In patients with CD and liver injury for whom a liver biopsy has been performed, histological changes are frequent (66%) but generally mild and nonspecific. 6,8,23,27 The abnormalities include periportal inflammation, bile duct obstruction, an increased number of Kupffer cells, mononuclear infiltration in the parenchyma, steatosis, and mild fibrosis. 6,8,23,24 Extensive fibrosis and cirrhosis have also been reported 21,22 ( Fig.…”

Section: Clinical Manifestationsmentioning

confidence: 99%

“…All the patients with nonspecific changes in the liver histology and a follow-up liver biopsy normalized the histological changes after adherence to a GFD. 6,23,27 This reversible, glutenrelated liver damage has been called celiac hepatitis. 28 An alternative etiology for liver injury should be explored in those patients with persistent hypertransaminasemia despite gluten exclusion.…”

Section: Managementmentioning

confidence: 99%

See 4 more Smart Citations

The liver in celiac disease

2007

View full text Add to dashboard Cite

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

show abstract