title: Hypertransaminasemia in Newly Diagnosed Pediatric Patients With Celiac Disease.
abstract: The aim of the present study was to determine the proportion of pediatric patients with celiac disease (CD) who had transaminases obtained at diagnosis and to determine the proportion with hypertransaminasemia.
  
  
  
  Data from newly diagnosed patients with CD at Nationwide Children's Hospital from February 2007 to March 2014 were retrospectively reviewed. Alanine transaminase (ALT) and aspartate transaminase (AST) values at diagnosis and after initiation of a gluten-free diet (GFD) were assessed.
  
  
  
  Of 388 patients (mean age 10.1 ± 4.4 years, 235 girls), 185 (47.7%) had transaminases obtained at the time of diagnosis. Twenty-eight of one hundred eighty-five (15.1%) had an elevated ALT and/or AST level with an average ALT 2.52 × upper limit of normal (ULN) and AST 1.87 × ULN. Those with hypertransaminasemia were younger than those with normal levels (6.31 ± 4.75 vs 11.00 ± 4.28 years, P < 0.0001). Sex, symptoms at diagnosis, and weight, height, and body mass index z scores were not predictive of elevated transaminases. Of the 21 patients with hypertransaminasemia at diagnosis who had repeat laboratory test results after starting the GFD, 15 (71.4%) normalized whereas 6 (28.6%) remained elevated.
  
  
  
  There is variation in practice among pediatric gastroenterologists in the assessment of transaminases in children with CD. Hypertransaminasemia is present at diagnosis in a significant proportion of children with CD although at a lower frequency than previously reported. Younger patients are more likely to have an elevation in transaminases. Abnormal transaminases normalize in the majority of patients within 1 year after initiation of a GFD.
authors.affiliation: *Division of Pediatric Gastroenterology, Hepatology, and Nutrition, University of Michigan Health System, Ann Arbor†Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Nationwide Children's Hospital, Columbus, OH.
authors.forename: Grace J
authors.initials: GJ
authors.lastname: Lee
authors.forename: Brendan
authors.initials: B
authors.lastname: Boyle
authors.forename: Tracy
authors.initials: T
authors.lastname: Ediger
authors.forename: Ivor
authors.initials: I
authors.lastname: Hill
mesh_terms: D000293:Adolescent; D000410:Alanine Transaminase / Q000097:blood*; D001219:Aspartate Aminotransferases / Q000097:blood*; D016022:Case-Control Studies; D002446:Celiac Disease / Q000097:blood* / Q000150:complications / Q000473:pathology; D002648:Child; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D008297:Male; D012189:Retrospective Studies
chemical_list: D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase