Open AccessTo screen or not to screen? Celiac antibodies in liver diseases
Author(s) -
Janaína Luz Narciso-Schiavon,
Leonardo Lucca Schiavon
Publication year - 2017
Publication title -
world journal of gastroenterology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.427
H-Index - 155
eISSN - 2219-2840
pISSN - 1007-9327
DOI - 10.3748/wjg.v23.i5.776
Subject(s) - medicine , autoimmune hepatitis , gastroenterology , primary sclerosing cholangitis , primary biliary cirrhosis , nonalcoholic fatty liver disease , context (archaeology) , cirrhosis , liver transplantation , hepatitis , gluten free , liver disease , fatty liver , hepatitis c , immunology , transplantation , disease , paleontology , biology
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.