Liver abnormalities in celiac disease and response to gluten free diet: A systematic review and meta‐analysis

Jena, Anuraag; Kumar‐M, Praveen; Kumar, Akhil; Birda, Chhagan Lal; Choudhury, Arup; Kumar, Naveen; Ramai, Daryl; Facciorusso, Antonio; Samanta, Jayanta

doi:10.1111/jgh.16039

Cited by 6 publications

(3 citation statements)

References 65 publications

(74 reference statements)

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“…Other large meta-analyses have shown that 86.39% of patients with confirmed celiac disease and liver manifestations (95% CI: 80.04-90.95, I2 = 74%) responded with improvement to a gluten-free diet [14]. ALT and albumin levels have improved 6 and 12 months after gluten-free diet initiation as well [15].…”

Section: Discussionmentioning

confidence: 96%

Incidentally Discovered Cryptogenic Cirrhosis in a Patient with Untreated Celiac Disease

Kosako Yost,

Alishahi

2023

Galician med. j.

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Celiac disease is a common gastrointestinal disorder that primarily manifests its effects on the small bowel. However, the systemic nature of this condition, especially regarding the liver, has been gaining some recognition in the literature. Mild liver disease is common, but few cases progress to cirrhosis. We present a case of an asymptomatic 78-year-old male with a past medical history of longstanding celiac disease, atrial fibrillation, heart failure with preserved ejection fraction, type 2 diabetes mellitus (DM), and chronic kidney disease stage III who underwent a computed tomography (CT) scan for thoracic aortic aneurysm surveillance. Incidentally, on a CT scan, cirrhotic liver morphology was discovered. Right upper quadrant ultrasound confirmed heterogenous echotexture of the liver, consistent with a diagnosis of cirrhosis. Laboratory work-up demonstrated elevated alkaline phosphatase of 171, tissue transglutaminase (TTG) significantly elevated at > 100, and a negative panel of other chronic liver disease labs, including negative anti-smooth muscle antibody, antimitochondrial antibody, liver kidney microsomal antibody, HFE gene, ceruloplasmin, alpha-1-antitrypsin, and alpha-fetoprotein < 2 ng/mL. The patient was not taking any hepatotoxic medications. Although the patient did have type 2 DM, his hemoglobin A1c was well-controlled at 5.9%, and he had no hyperlipidemia and a normal body mass index, making a metabolic etiology of liver disease less likely. The patient had no significant alcohol use, either. The only patient’s major risk factor for liver disease was his untreated celiac disease, diagnosed in infancy. The patient was instructed to avoid any gluten, alcohol, and other hepatotoxic substances and was subsequently followed by a gastroenterologist. The following case report explores the pathogenesis of celiac-associated liver disease and the effect a gluten-free diet can have on the small bowel and the liver.

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Section: Discussionmentioning

confidence: 96%

Incidentally Discovered Cryptogenic Cirrhosis in a Patient with Untreated Celiac Disease

Kosako Yost,

Alishahi

2023

Galician med. j.

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“…Low high density lipoprotein (HDL) has consistently been associated with untreated CD [40], and the combination of unexplained iron-de ciency anemia and low HDL may be particularly suggestive of CD [41]. Longitudinal studies have found that these lab abnormalities typically resolve after initiation of a GFD, including anemia [42], transaminitis [43], and low HDL [44,45].…”

Section: Discussionmentioning

confidence: 99%

A Machine Learning Tool for Early Identification of Celiac Disease Autoimmunity

Dreyfuss,

Getz,

Lebwohl

et al. 2024

Preprint

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Identifying which patients should undergo serologic screening for celiac disease (CD) may help diagnose patients who otherwise often experience diagnostic delays or remain undiagnosed. Using anonymized outpatient data from the electronic medical records of Maccabi Healthcare Services, we developed and evaluated a gradient boosted trees model to classify patients as at-risk for CD autoimmunity prior to first documented diagnosis or positive serum tissue transglutaminase (tTG-IgA). A train set of highly seropositive (tTG-IgA > 10X ULN) cases (n = 677) with likely CD and controls (n = 176,293) with no evidence of CD autoimmunity was used for model development. Input features included demographic information and commonly available laboratory results. The model was then evaluated for discriminative ability as measured by AUC on a distinct set of highly seropositive cases (n = 153) and controls (n = 41,087). Performance was estimated at one (AUC = 0.84), two (AUC = 0.81), three (AUC = 0.82) and four (AUC = 0.79) years prior to first documented evidence of disease. The model’s ability to distinguish cases of incident CD autoimmunity from controls shows promise as a potential clinical tool to identify patients at increased risk for having undiagnosed celiac disease in the community for serologic screening.

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“…Формирование ГТ может быть результатом включения аутоиммунных процессов, приводящих к повреждению паренхимы печени анти-ТТГ, что подтверждается нормализацией уровней АЛТ и АСТ на фоне строгого соблюдения безглютеновой диеты [9,16,19]. Кроме того, повреждение печени при целиакии может быть обусловлено выработкой антител к гепатоцитам у лиц, имеющих генетическую предрасположенность к формированию аутоиммунных заболеваний.…”

Section: обсуждение результатовunclassified

Liver damage in children and adolescents with newly diagnosed celiac disease: clinical and anamnestic, serological and morphological patterns

Cherkasova¹,

Klimov²,

Kuryaninova³

et al. 2023

Terapevticheskii arkhiv

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Hypertransaminasemia is a common extra-intestinal manifestation of celiac disease. Aim. To analyze the frequency of hypertransaminasemia, clinical and anamnestic, serological and morphological picture in children in the active period of celiac disease. Materials and methods. The study included 272 children with celiac disease aged from 8 months to 17 years. The patients were divided into two groups: the first children with hypertransaminasemia, the second without hypertransaminasemia. Results. Hypertransaminasemia was detected in 55.9% of children with celiac disease. The age of manifestation of the disease in the first group was 1.0 [0.5; 2.0] years, in the second group 1.9 [0.5; 4.0] years (p=0.0004). Children of the first group were diagnosed at 2.5 [1.7; 4.9] years, the second group at 4.9 [3.0; 10.8] years (p0.001). The duration of the latency period in children of the first and second groups was 1.4 [0.6; 3.1] years and 2.4 [0.9; 4.3] years, respectively (p=0.002). The average values of IgA anti-tTG antibodies in children of the analyzed groups did not differ, and the indicators of IgG anti-tTG antibodies in the first group were 1.6 (p=0.04) times higher. The level of EMA in children with hypertransaminasemia was 2 times higher than in children without hypertransaminasemia. Conclusion. Hypertransaminasemia is more often detected in young children with early manifestation of the disease, increases with the deepening of atrophy in the mucous membrane of the small intestine. Higher titers of celiac-specific antibodies were detected in children with hypertransaminasemia.

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Liver abnormalities in celiac disease and response to gluten free diet: A systematic review and meta‐analysis

Cited by 6 publications

References 65 publications

Incidentally Discovered Cryptogenic Cirrhosis in a Patient with Untreated Celiac Disease

Incidentally Discovered Cryptogenic Cirrhosis in a Patient with Untreated Celiac Disease

A Machine Learning Tool for Early Identification of Celiac Disease Autoimmunity

Liver damage in children and adolescents with newly diagnosed celiac disease: clinical and anamnestic, serological and morphological patterns

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