Open AccessGluten-Free hepatomiracle in “celiac hepatitis”: A case highlighting the rare occurrence of nutrition-induced near total reversal of advanced steatohepatitis and cirrhosis
Author(s) -
Kavita Gaur,
Puja Sakhuja,
Amarender Singh Puri,
Kaushik Majumdar
Publication year - 2016
Publication title -
the saudi journal of gastroenterology/saudi journal of gastroenterology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.608
H-Index - 32
eISSN - 1998-4049
pISSN - 1319-3767
DOI - 10.4103/1319-3767.195554
Subject(s) - medicine , steatohepatitis , cirrhosis , gastroenterology , steatosis , fibrosis , liver biopsy , gluten free , enteropathy , biopsy , liver disease , atrophy , hepatitis c , disease , pathology , fatty liver
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.