title: Celiac disease and chronic liver disease: is there a relationship?
abstract: Celiac disease is a multisystem disease, and the liver is affected in a subset of patients. We herein present a case series of 25 patients with celiac disease who had evidence of cirrhosis of the liver. We retrospectively reviewed the case records of patients with celiac disease having concomitant cirrhosis. The diagnosis of celiac disease was made on the basis of the modified European Society of Pediatric Gastroenterology, Hepatology, and Nutrition criteria. Of 25 patients (nine males; mean age 28.8 ± 16.6 years) with celiac disease and cirrhosis, 17 patients presented predominantly with cirrhosis, while 8 presented primarily with celiac disease. Five patients had known cause of cirrhosis (autoimmune hepatitis, three; PBC, one; hepatic venous outflow tract obstruction, one); the remaining 20 were cryptogenic. Gluten-free diet led to improvement in diarrhea and anemia and to a better control of ascites and other features of liver failure. Some patients with cryptogenic cirrhosis have coexistent celiac disease, and they show response to gluten-free diet. Patients with cryptogenic cirrhosis should be screened for celiac disease.
authors.affiliation: Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110 029, India.
authors.forename: Prashant
authors.initials: P
authors.lastname: Singh
authors.forename: Abhishek
authors.initials: A
authors.lastname: Agnihotri
authors.forename: Gaurav
authors.initials: G
authors.lastname: Jindal
authors.forename: Piyush Kumar
authors.initials: PK
authors.lastname: Sharma
authors.forename: Minakshi
authors.initials: M
authors.lastname: Sharma
authors.forename: Prasenjit
authors.initials: P
authors.lastname: Das
authors.forename: Datta
authors.initials: D
authors.lastname: Gupta
authors.forename: Govind K
authors.initials: GK
authors.lastname: Makharia
mesh_terms: D000328:Adult; D002446:Celiac Disease / Q000150:complications* / Q000178:diet therapy*; D055050:Diet, Gluten-Free; D016145:Endoscopy, Digestive System; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000178:diet therapy* / Q000209:etiology*; D008297:Male; D012189:Retrospective Studies
references.citation: Gastroenterol Clin Biol. 2010 Nov;34(11):621-4
references.pmid: 20934289
references.citation: Lancet. 1978 Feb 4;1(8058):230-3
references.pmid: 74661
references.citation: Aliment Pharmacol Ther. 2005 Mar 1;21(5):515-8
references.pmid: 15740533
references.citation: Ital J Gastroenterol. 1992 Oct;24(8):457-60
references.pmid: 1421449
references.citation: Scand J Gastroenterol. 1994 Jul;29(7):661-4
references.pmid: 7939405
references.citation: Hepatology. 1995 Sep;22(3):833-6
references.pmid: 7657290
references.citation: J Gastroenterol Hepatol. 2011 May;26(5):894-900
references.pmid: 21182543
references.citation: Biomed Pharmacother. 2000 Aug;54(7):368-72
references.pmid: 10989975
references.citation: Eur J Gastroenterol Hepatol. 1999 Mar;11(3):283-8
references.pmid: 10333201
references.citation: Gastroenterology. 2002 Apr;122(4):881-8
references.pmid: 11910339
references.citation: J Pediatr Gastroenterol Nutr. 2012 Jan;54(1):136-60
references.pmid: 22197856
references.citation: J Clin Lab Anal. 2005;19(1):6-10
references.pmid: 15645466
references.citation: Am J Clin Pathol. 2011 Jul;136(1):128-37
references.pmid: 21685040
references.citation: Clin Gastroenterol Hepatol. 2007 Jan;5(1):63-69.e1
references.pmid: 17161656
references.citation: Gastroenterology. 2005 Apr;128(4 Suppl 1):S47-51
references.pmid: 15825126
references.citation: Indian J Gastroenterol. 2007 Jul-Aug;26(4):162-6
references.pmid: 17986741
references.citation: Scand J Gastroenterol. 1997 Nov;32(11):1162-7
references.pmid: 9399399
references.citation: Dig Liver Dis. 2010 Sep;42(9):620-3
references.pmid: 20236872
references.citation: Scand J Gastroenterol. 1990 Jul;25(7):656-62
references.pmid: 2396080
references.citation: Dig Dis Sci. 1998 Oct;43(10):2190-5
references.pmid: 9790453
references.citation: Nat Rev Gastroenterol Hepatol. 2012 May 15;9(6):305-6
references.pmid: 22585134