title: Transient elastography in patients with celiac disease: a noninvasive method to detect liver involvement associated with celiac disease.
abstract: BACKGROUND
  Liver involvement in celiac disease (CD) is clinically relevant and could require specific treatment in addition to gluten-free diet (GFD). Transient elastography (TE), a noninvasive tool for assessing liver stiffness (LS), has widely been reported as an accurate surrogate marker of liver fibrosis.
  
  
  OBJECTIVE
  To prospectively identify celiac patients with liver involvement by TE and to assess the effect of GFD.
  
  
  METHODS
  Ninety-five histologically confirmed CD patients (24 newly diagnosed) were consecutively evaluated by TE and compared with 146 patients with chronic hepatitis C (HCV) and 54 healthy subjects.
  
  
  RESULTS
  LS ranged between 2.8 and 6.7 kPa (median 4.9) in healthy subjects, defining 6.9 kPa as the upper reference limit (2 SD above the mean levels). TE was above 6.9 kPa in 10 (10.5%) CD patients. Median TE values resulted significantly higher in CD patients with hypertransaminasemia than those without [6.1 vs. 4.2 kPa (p < 0.01)]. Among the 24 newly diagnosed patients with CD, median TE values declined from 4.4 to 4 kPa, after 6 months of GFD, resulting below 6.9 kPa in 100% of the patients.
  
  
  CONCLUSIONS
  A subset of CD patients with hypertransaminasemia showed liver involvement by TE. Accordingly, based on its accuracy in predicting liver fibrosis, TE could be used to identify those CD patients suitable for liver biopsy.
authors.affiliation: Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Gastroenterology Unit 2, Milan, Italy. sara.massironi@libero.it
authors.forename: Sara
authors.initials: S
authors.lastname: Massironi
authors.forename: Roberta Elisa
authors.initials: RE
authors.lastname: Rossi
authors.forename: Mirella
authors.initials: M
authors.lastname: Fraquelli
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Bardella
authors.forename: Luca
authors.initials: L
authors.lastname: Elli
authors.forename: Marco
authors.initials: M
authors.lastname: Maggioni
authors.forename: Serena
authors.initials: S
authors.lastname: Della Valle
authors.forename: Matilde Pia
authors.initials: MP
authors.lastname: Spampatti
authors.forename: Massimo
authors.initials: M
authors.lastname: Colombo
authors.forename: Dario
authors.initials: D
authors.lastname: Conte
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D002446:Celiac Disease / Q000150:complications* / Q000178:diet therapy; D055050:Diet, Gluten-Free; D054459:Elasticity Imaging Techniques; D005260:Female; D019698:Hepatitis C, Chronic / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging* / Q000209:etiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult