title: Gluten-Free hepatomiracle in "celiac hepatitis": A case highlighting the rare occurrence of nutrition-induced near total reversal of advanced steatohepatitis and cirrhosis.
abstract: Regression of hepatic fibrosis is increasingly becoming a reality, both in clinical as well as experimental models. Reversal or near-total regression of marked liver steatohepatitis and fibrosis, however, remains a rare event. We report the case of a 20-year-old female presenting with diarrhea due to celiac disease and biopsy proven cirrhosis with portal hypertension who had a remarkable clinical improvement in response to a gluten free diet (GFD). A follow-up liver biopsy 9 months after the initiation of GFD revealed a remarkable regression of both fibrosis as well as steatosis. Villous atrophy, as seen in patients with celiac disease, could lead to a deprivation of trophic factors leading to liver injury and subsequent cirrhosis. A gluten-free dietary regimen can produce a reversal of fibrosis leading to the amelioration of symptoms associated even with advanced liver disease.
authors.affiliation: Department of Pathology, GB Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India.
authors.forename: Kavita
authors.initials: K
authors.lastname: Gaur
authors.affiliation: Department of Pathology, GB Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India.
authors.forename: Puja
authors.initials: P
authors.lastname: Sakhuja
authors.affiliation: Department of Gastroenterology, GB Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India.
authors.forename: Amarender S
authors.initials: AS
authors.lastname: Puri
authors.affiliation: Department of Pathology, GB Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India.
authors.forename: Kaushik
authors.initials: K
authors.lastname: Majumdar
mesh_terms: D000359:Aftercare; D002446:Celiac Disease / Q000178:diet therapy*; D003967:Diarrhea / Q000209:etiology; D055050:Diet, Gluten-Free / Q000379:methods*; D005234:Fatty Liver / Q000178:diet therapy*; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000178:diet therapy*; D016896:Treatment Outcome; D055815:Young Adult