title: Celiac disease in autoimmune cholestatic liver disorders.
abstract: OBJECTIVE
  In this study, serological screening for celiac disease (CD) was performed in patients with autoimmune cholestasis to define the prevalence of such an association and to evaluate the impact of gluten withdrawal on liver disease associated with gluten sensitive enteropathy.
  
  
  METHODS
  Immunoglobulin A endomysial, human and guinea pig tissue transglutaminase antibodies, and immunoglobulin A and G gliadin antibodies were sought in 255 patients with primary biliary cirrhosis, autoimmune cholangitis, and primary sclerosing cholangitis.
  
  
  RESULTS
  Immunoglobulin A endomysial and human tissue transglutaminase antibodies were positive in nine patients (seven primary biliary cirrhosis, one autoimmune cholangitis, and one primary sclerosing cholangitis), whose duodenal biopsy results showed villous atrophy consistent with CD. Two of these patients had a malabsorption syndrome, and one had iron-deficiency anemia. Clinical and biochemical signs of cholestasis did not improve after gluten withdrawal in the three patients with severe liver disease. A longer follow-up of the six celiac patients with mild liver damage is needed to clarify whether gluten restriction can contribute to slow down the progression of liver disease.
  
  
  CONCLUSIONS
  The high prevalence of CD (3.5%) in autoimmune cholestasis suggests that serological screening for CD should be routinely performed in such patients by immunoglobulin A endomysial or human tissue transglutaminase antibodies.
authors.affiliation: Department of Internal Medicine, Cardioangiology, Hepatology, S. Orsola-Malpighi Policlinic, University of Bologna, Italy.
authors.forename: Umberto
authors.initials: U
authors.lastname: Volta
authors.forename: Luis
authors.initials: L
authors.lastname: Rodrigo
authors.forename: Alessandro
authors.initials: A
authors.lastname: Granito
authors.forename: Nunzio
authors.initials: N
authors.lastname: Petrolini
authors.forename: Paolo
authors.initials: P
authors.lastname: Muratori
authors.forename: Luigi
authors.initials: L
authors.lastname: Muratori
authors.forename: Antonio
authors.initials: A
authors.lastname: Linares
authors.forename: Lorenza
authors.initials: L
authors.lastname: Veronesi
authors.forename: Dolores
authors.initials: D
authors.lastname: Fuentes
authors.forename: Daniela
authors.initials: D
authors.lastname: Zauli
authors.forename: Francesco B
authors.initials: FB
authors.lastname: Bianchi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001323:Autoantibodies / Q000032:analysis; D001327:Autoimmune Diseases / Q000150:complications*; D001706:Biopsy; D002446:Celiac Disease / Q000150:complications* / Q000175:diagnosis / Q000178:diet therapy / Q000473:pathology; D002761:Cholangitis / Q000150:complications*; D015209:Cholangitis, Sclerosing / Q000150:complications; D005260:Female; D019204:GTP-Binding Proteins / Q000276:immunology; D005903:Gliadin / Q000276:immunology; D005983:Glutens / Q000008:administration & dosage; D006801:Humans; D007070:Immunoglobulin A / Q000032:analysis; D007074:Immunoglobulin G / Q000032:analysis; D007413:Intestinal Mucosa / Q000473:pathology; D008105:Liver Cirrhosis, Biliary / Q000150:complications*; D008297:Male; D008875:Middle Aged; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D011503:Transglutaminases / Q000276:immunology
chemical_list: D001323:Autoantibodies; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D005983:Glutens; D005903:Gliadin; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D011503:Transglutaminases; D019204:GTP-Binding Proteins