Liver transplantation in a child with celiac disease.
Recently, an atypical form of celiac disease (CD) has been identified, in which gastrointestinal symptoms are less pronounced. Other organs can be more or less severely affected, and the disease might be unrecognized and undiagnosed. In some cases, hypertransaminasemia has been indicated as the first symptom of CD in infancy. A direct relationship between liver damage and glutensensitivity has been proven by the disappearance of biochemical signs and histological lesions of the liver after the initiation of the gluten-free diet. The present case report is of a 14-year-old girl affected by CD and severe hepatic failure who underwent a liver transplant. To our knowledge, this case is the first report of liver involvement related to CD which is so severe as to require a liver transplant in a child. Because most patients with CD remain undiagnosed, and, as observed in the present report, untreated CD with subclinical hepatic involvement can lead to more serious liver disease, a more aggressive diagnostic work-up for CD in the general population is warranted.
Pavone
Piero
P
Department of Pediatrics, University of Catania, Via Santa Sofia 78, 95123 Catania, Italy. ppavone@mbox.unict.it
Gruttadauria
Salvatore
S
Leonardi
Salvatore
S
Sorge
Giovanni
G
Minervini
Marta Ida
MI
Greco
Filippo
F
La Rosa
Mario
M
Marino
Ignazio
I
D000293:Adolescent; D001706:Biopsy; D002446:Celiac Disease / Q000150:complications* / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017093:Liver Failure / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D016031:Liver Transplantation; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed