title: [Hypertransaminasaemia and impaired liver function in a patient with oligosymptomatic celiac disease].
abstract: Hypertransaminasaemia and impaired liver function in a patient with oligosymptomatic celiac disease. We describe the case of a 45-year-old man who was referred for evaluation of elevated aminotransferases. One year before referral the patient developed an ischemic stroke followed by a subdural hematoma three months later. In our outpatient clinic the patient presented with a malabsorption syndrome including diminished vitamin-K-dependent clotting factors. Serologic testing was positive for IgA antigliadin antibodies and IgA antiendomysial antibodies. Celiac disease was confirmed by an upper endoscopy examination and biopsies obtained from the distal duodenum. Histological examination showed villous atrophy, crypt hyperplasia and an increase in intraepithelial lymphocyte count consistent with celiac disease. After initiation of a gluten-free diet the malabsorption syndrome as well as liver dysfunction improved. Serum aminotransferase levels normalized within 6 months. The clinical course demonstrates involvement of the liver in patients with celiac disease.
authors.affiliation: Medizinische Klinik II, Klinikum der Johann-Wolfgang-Goethe-Universität, Frankfurt/Main, Germany.
authors.forename: W P
authors.initials: WP
authors.lastname: Hofmann
authors.forename: C F
authors.initials: CF
authors.lastname: Dietrich
authors.forename: W
authors.initials: W
authors.lastname: Holtmeier
authors.forename: W F
authors.initials: WF
authors.lastname: Caspary
authors.forename: S
authors.initials: S
authors.lastname: Zeuzem
mesh_terms: D000410:Alanine Transaminase / Q000097:blood*; D001219:Aspartate Aminotransferases / Q000097:blood*; D002446:Celiac Disease / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D003937:Diagnosis, Differential; D016099:Endoscopy, Gastrointestinal; D005903:Gliadin / Q000276:immunology; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D007413:Intestinal Mucosa / Q000473:pathology; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D014813:Vitamin K Deficiency / Q000097:blood / Q000175:diagnosis
chemical_list: D007070:Immunoglobulin A; D005903:Gliadin; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase