To screen or not to screen? Celiac antibodies in liver diseases

Narciso-Schiavon, Janaína Luz; Schiavon, Leonardo Lucca

doi:10.3748/wjg.v23.i5.776

Cited by 19 publications

(15 citation statements)

References 186 publications

(190 reference statements)

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“…Cryptogenic hypertransaminasaemia (celiac hepatitis), a common extraintestinal presentation of CD, is closely related to gluten intake. Additionally, CD can simply coexist as a coincidental finding with several liver diseases, such as non-alcoholic fatty liver disease (NAFLD) (and its subgroup termed non-alcoholic steatohepatitis (NASH)), chronic viral hepatitis B or C, alcoholic liver disease, hemochromatosis, Wilson’s disease, and other hereditary hepatic diseases [ 3 , 44 , 49 , 50 , 51 ]. Swedish epidemiological studies have revealed that patients with CD have an increased risk of both prior and subsequent liver disease, four-times and six-times, respectively [ 52 ], and an eight-times increased risk of mortality from liver cirrhosis [ 53 ]; however, no increased risk of liver transplantation was found (HR, 1.07; 95% CI, 0.12–9.62; p = 0.954) [ 52 ].…”

Section: Celiac Disease and Liver Disorders In The Clinical Contexmentioning

confidence: 99%

“…The pathophysiology of CD associated AILD is not driven directly by gluten, since good adherence to a GFD alone usually does not lead to an improvement in liver tests or in the course of hepatic disease [ 3 , 8 , 44 , 49 , 50 ]. Patients with AILD and CD require both specific immunosuppressive therapy for the liver disorder as well as a GFD.…”

Section: Celiac Disease and Liver Disorders In The Clinical Contexmentioning

confidence: 99%

“…However, when metabolic syndrome is absent, NAFLD may be related to concomitant CD. Therefore, in the absence of type 2 diabetes mellitus or obesity, and when other causes of liver disease are excluded, patients with NAFLD should be screened for CD [ 50 ].…”

Section: Celiac Disease and Liver Disorders In The Clinical Contexmentioning

confidence: 99%

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Celiac Disease and Liver Disorders: From Putative Pathogenesis to Clinical Implications

et al. 2018

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Immunologically mediated liver diseases belong to the common extraintestinal manifestations of celiac disease. We have reviewed the current literature that addresses the association between celiac disease and liver disorders. We searched relevant articles on MEDLINE/PubMed up to 15 June 2018. The objective of the article is to provide a comprehensive and up-to-date review on the latest hypotheses explaining the pathogenetic relationship between celiac disease and liver injury. Besides the involvement of gut–liver axis, tissue transglutaminase antibodies, and impairment of intestinal barrier, we integrate the latest achievements made in elucidation of the role of gut microbiota in celiac disease and liver disorders, that has not yet been sufficiently discussed in the literature in this context. The further objective is to provide a complete clinical overview on the types of liver diseases frequently found in celiac disease. In conclusion, the review highlights the clinical implication, recommend a rational approach for managing elevated transaminases in celiac patients, and underscore the importance of screening for celiac disease in patients with associated liver disease.

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Section: Celiac Disease and Liver Disorders In The Clinical Contexmentioning

confidence: 99%

Section: Celiac Disease and Liver Disorders In The Clinical Contexmentioning

confidence: 99%

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Celiac Disease and Liver Disorders: From Putative Pathogenesis to Clinical Implications

et al. 2018

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“…Unlike CD, nutrient deficiencies such as iron, vitamin D and vitamin B 12 deficiencies are not significantly seen in NCGS[ 34 ]. NCGS also has a lesser association with autoimmune disorders when compared with CD[ 14 , 35 ].…”

Section: Clinical Presentationmentioning

confidence: 99%

Non-celiac gluten sensitivity: All wheat attack is not celiac

Igbinedion¹,

Ansari²,

Vasikaran³

et al. 2017

WJG

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Currently, 1% of the United States population holds a diagnosis for celiac disease (CD), however, a more recently recognized and possibly related condition, “non-celiac gluten sensitivity” (NCGS) has been suggested to affect up to 6% of the United States public. While reliable clinical tests for CD exist, diagnosing individuals affected by NCGS is still complicated by the lack of reliable biomarkers and reliance upon a broad set of intestinal and extra intestinal symptoms possibly provoked by gluten. NCGS has been proposed to exhibit an innate immune response activated by gluten and several other wheat proteins. At present, an enormous food industry has developed to supply gluten-free products (GFP) with GFP sales in 2014 approaching $1 billion, with estimations projecting sales to reach $2 billion in the year 2020. The enormous demand for GFP also reflects a popular misconception among consumers that gluten avoidance is part of a healthy lifestyle choice. Features of NCGS and other gluten related disorders (e.g., irritable bowel syndrome) call for a review of current distinctive diagnostic criteria that distinguish each, and identification of biomarkers selective or specific for NCGS. The aim of this paper is to review our current understanding of NCGS, highlighting the remaining challenges and questions which may improve its diagnosis and treatment.

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“…Rarely, CD can be associated with severe autoimmune liver disease [12,26,27]. In contrast to IHTS associated with CD, which disappears on gluten-free diet, autoimmune diseases of the liver in these patients are gluten-independent [12,26,28].…”

Section: Discussionmentioning

confidence: 99%

Isolated hypertransaminasemia in children up to two years with classical celiac disease

Radlovic

Lekovic

Mladenovic³

et al. 2019

Srp Arh Celok Lek

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Introduction/Objective Isolated hypertransaminasemia (IHTS) is a common, benign, and transient appearance in patients with celiac disease (CD). The aim of this study is to determine the frequency of IHTS in children up to two years old with clinically classical CD, as well as its connection with the onset of the first symptoms of the disease, the age of diagnosis, the clinical and laboratory nutritional parameters, and the degree of damage of small intestinal mucosa. Methods The study was based on a sample of 82 children, 55 female and 27 male, ages 7-24 (14.28 ± 4.41) months. The diagnosis of CD was based on the revised ESPGHAN criteria and the activity of serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) by standard laboratory methods. Results IHTS was found in 39 (47.56%) patients, 27 of whom (69.23%) had elevated levels of both transaminases and 12 of only one-eight of AST and four of ALT. The increase in relation to the aforementioned reference value for ALT was 1.1-10.08 (1.67 ± 1.73), and for AST it was 1.08-7.91 (1.56 ± 1.29) times. In patients with IHTS compared to those with normal transaminasemia, the age of onset of CD was significantly lower (9.83 ± 3.69 vs. 12.95 ± 4.43 months, p = 0.001), as well as the age of diagnosis (12.97 ± 3.88 vs. 15.47 ± 4.56 months; p = 0.01), while the differences in the other observed parameters were not significant. Conclusions IHTS occurs in almost half of children up to two years old with classical CD. Hypertransaminasemia is in most cases mild and significantly more frequent in patients with earlier clinical expression of the CD.

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To screen or not to screen? Celiac antibodies in liver diseases

Cited by 19 publications

References 186 publications

Celiac Disease and Liver Disorders: From Putative Pathogenesis to Clinical Implications

Celiac Disease and Liver Disorders: From Putative Pathogenesis to Clinical Implications

Non-celiac gluten sensitivity: All wheat attack is not celiac

Isolated hypertransaminasemia in children up to two years with classical celiac disease

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