Coeliac disease in autoimmune liver disease: a cross-sectional study and a systematic review.
BACKGROUND
Several studies have reported an association between coeliac disease and autoimmune liver disease, but there is little information on the prevalence of coeliac disease in certain autoimmune liver diseases, particularly from non-European, non-American countries.


OBJECTIVE
To investigate prevalence of coeliac disease in autoimmune liver disease in Iran and to summarize previous literature.


METHODS
We investigated prevalence of coeliac disease among 100 autoimmune liver disease patients and compared it with the prevalence in healthy individuals. We also performed an extensive search of the English literature in PubMed Database.


RESULTS
We found substantially elevated prevalence of coeliac disease in patients with overlap syndrome (10-15%) compared to the general population (0.1-1%). To a lesser extent, the prevalence was high in patients with autoimmune hepatitis (2-4%). In our systematic review, prevalence of coeliac disease in autoimmune hepatitis in the majority of studies was 4% or more; several studies also reported such prevalence in primary biliary cirrhosis.


CONCLUSIONS
Since coeliac disease is common among patients with autoimmune liver disease, screening autoimmune liver disease patients for coeliac disease is indicated. Although the magnitude of benefit from a gluten-free diet in reversing autoimmune liver disease in patients with coeliac disease is controversial, it may reduce the risk of further complications of coeliac disease.
Digestive Disease Research Center, Shariati Hospital, Tehran University of Medical Sciences, North Kargar Street, 14117 Tehran, Iran.
Foroozandeh
F
Mirzaagha
Sepideh Hagh
SH
Azali
Farhad
F
Islami
Farhad
F
Zamani
Elias
E
Khalilipour
Morteza
M
Khatibian
Reza
R
Malekzadeh
D000328:Adult; D002446:Celiac Disease / Q000150:complications* / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D019693:Hepatitis, Autoimmune / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D007492:Iran / Q000453:epidemiology; D008105:Liver Cirrhosis, Biliary / Q000150:complications / Q000453:epidemiology; D008297:Male; D015995:Prevalence; D013577:Syndrome