title: To screen or not to screen? Celiac antibodies in liver diseases.
abstract: Celiac disease (CD) is a systemic immune-mediated disorder triggered by dietary gluten in genetically predisposed individuals. The typical symptoms are anemia, diarrhea, fatigue, weight loss, and abdominal pain. CD has been reported in patients with primary sclerosing cholangitis, primary biliary cholangitis, autoimmune hepatitis, aminotransferase elevations, nonalcoholic fatty liver disease, hepatitis B, hepatitis C, portal hypertension and liver cirrhosis. We evaluate recommendations for active screening for CD in patients with liver diseases, and the effect of a gluten-free diet in these different settings. Active screening for CD is recommended in patients with liver diseases, particularly in those with autoimmune disorders, steatosis in the absence of metabolic syndrome, noncirrhotic intrahepatic portal hypertension, cryptogenic cirrhosis, and in the context of liver transplantation. In hepatitis C, diagnosis of CD can be important as a relative contraindication to interferon use. Gluten-free diet ameliorates the symptoms associated with CD; however, the associated liver disease may improve, remain the same, or progress.
authors.affiliation: Janaína Luz Narciso-Schiavon, Leonardo Lucca Schiavon, Department of Internal Medicine, Division of Gastroenterology, Federal University of Santa Catarina, Santa Catarina 88040-900, Brazil.
authors.forename: Janaína Luz
authors.initials: JL
authors.lastname: Narciso-Schiavon
authors.affiliation: Janaína Luz Narciso-Schiavon, Leonardo Lucca Schiavon, Department of Internal Medicine, Division of Gastroenterology, Federal University of Santa Catarina, Santa Catarina 88040-900, Brazil.
authors.forename: Leonardo Lucca
authors.initials: LL
authors.lastname: Schiavon
mesh_terms: D000906:Antibodies / Q000097:blood*; D002446:Celiac Disease / Q000150:complications* / Q000175:diagnosis* / Q000276:immunology; D015209:Cholangitis, Sclerosing / Q000150:complications / Q000276:immunology; D055050:Diet, Gluten-Free; D005983:Glutens / Q000009:adverse effects / Q000276:immunology; D006509:Hepatitis B / Q000150:complications / Q000276:immunology; D006526:Hepatitis C / Q000150:complications / Q000276:immunology; D019693:Hepatitis, Autoimmune / Q000150:complications / Q000276:immunology; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications / Q000276:immunology; D008103:Liver Cirrhosis / Q000150:complications / Q000276:immunology; D008105:Liver Cirrhosis, Biliary / Q000150:complications / Q000276:immunology; D008107:Liver Diseases / Q000150:complications* / Q000276:immunology*; D017093:Liver Failure / Q000150:complications / Q000276:immunology; D016031:Liver Transplantation; D065626:Non-alcoholic Fatty Liver Disease / Q000150:complications / Q000276:immunology
chemical_list: D000906:Antibodies; D005983:Glutens
keywords: Autoimmune; Biliary; Celiac disease; Cholangitis; Hepatitis; Hypertension; Liver cirrhosis; Portal; Sclerosing