title: Screening patients with celiac disease for primary biliary cirrhosis and vice versa.
abstract: BACKGROUND
  An association between celiac disease and primary biliary cirrhosis has been reported in a few cases, mainly as individual case reports.
  
  
  OBJECTIVE
  To screen adult patients with celiac disease for primary biliary cirrhosis and patients with primary biliary cirrhosis for intestinal celiac involvement.
  
  
  METHODS
  The celiac group consisted of 336 adults (218 women and 118 men; mean age, 36 yr; range 18-74 yr) with celiac disease diagnosed by serological and histological tests, 38 with newly diagnosed celiac disease and 298 with previously diagnosed celiac disease who were consuming a gluten-free diet. The mean follow-up period was 6 yr (range, 1-16 yr). Liver function parameters and autoantibody levels were determined, and, when indicated, histological tests were performed. The biliary cirrhosis group consisted of 65 subjects (58 women and seven men) (mean age, 59 yr; range, 35-67 yr) with primary biliary cirrhosis diagnosed 1-17 years previously (mean, 7 yr) on the basis of the usual biochemical, serological, and histological criteria. Antigliadin and antiendomysium antibody levels were determined, and two biopsy specimens from the distal duodenum obtained during endoscopy were evaluated.
  
  
  RESULTS
  In patients with celiac disease, impairment of liver function was frequently found at diagnosis (16 of 38, or 44%), but primary biliary cirrhosis was diagnosed in only one case. In patients with primary biliary cirrhosis, no cases of celiac disease, as currently defined, were found.
  
  
  CONCLUSIONS
  Our findings indicate that celiac disease and primary biliary cirrhosis are rarely associated and support the hypothesis that the intestinal lesions per se are not responsible for the liver disease.
authors.affiliation: Cattedra di Gastroenterologia, Istituto di Scienze Mediche, IRCCS Ospedale Maggiore, Università di Milano, Italy.
authors.forename: M T
authors.initials: MT
authors.lastname: Bardella
authors.forename: M
authors.initials: M
authors.lastname: Quatrini
authors.forename: M
authors.initials: M
authors.lastname: Zuin
authors.forename: M
authors.initials: M
authors.lastname: Podda
authors.forename: L
authors.initials: L
authors.lastname: Cesarini
authors.forename: P
authors.initials: P
authors.lastname: Velio
authors.forename: P
authors.initials: P
authors.lastname: Bianchi
authors.forename: D
authors.initials: D
authors.lastname: Conte
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001323:Autoantibodies / Q000097:blood; D001706:Biopsy; D002446:Celiac Disease / Q000150:complications / Q000175:diagnosis* / Q000178:diet therapy / Q000276:immunology / Q000503:physiopathology; D018753:Diet, Protein-Restricted; D004044:Dietary Proteins / Q000008:administration & dosage; D004386:Duodenum / Q000473:pathology; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D005500:Follow-Up Studies; D005903:Gliadin / Q000032:analysis / Q000276:immunology; D005983:Glutens / Q000008:administration & dosage; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D008099:Liver / Q000503:physiopathology; D008105:Liver Cirrhosis, Biliary / Q000150:complications / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009210:Myofibrils / Q000737:chemistry / Q000276:immunology
chemical_list: D001323:Autoantibodies; D004044:Dietary Proteins; D007070:Immunoglobulin A; D005983:Glutens; D005903:Gliadin