Prasad Kaushal K, Debi Uma, Sinha Saroj K, Nain Chander K, Singh Kartar
Department of Superspeciality of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh 160 012, India.
Int J Hepatol. 2011;2011:438184. doi: 10.4061/2011/438184. Epub 2010 Nov 14.
This communication reviews recent literature and summarizes hepatobiliary abnormalities that may complicate the clinical course of celiac disease. A wide spectrum of hepatobiliary diseases has been described, including asymptomatic elevations of liver enzyme levels, nonspecific hepatitis, nonalcoholic fatty liver disease, and autoimmune and cholestatic liver disease. Moreover, in the majority of patients, liver enzyme levels will normalize on a gluten-free diet. In addition, celiac disease may be associated with rare hepatic complications, such as hepatic T-cell lymphoma. Because many celiac patients do not have overt gastrointestinal symptoms, a high index of suspicion is required. Simple methods of detecting celiac disease such as serum antibody tests help in the early identification of the disease, thus preventing serious complications of the disorder. The IgG DGP antibody test and IgA tTG antibody test used in combination are an excellent screening test for suspected cases of celiac disease.
本通讯回顾了近期文献，并总结了可能使乳糜泻临床病程复杂化的肝胆异常情况。已描述了多种肝胆疾病，包括无症状的肝酶水平升高、非特异性肝炎、非酒精性脂肪性肝病以及自身免疫性和胆汁淤积性肝病。此外，大多数患者在采用无麸质饮食后肝酶水平会恢复正常。另外，乳糜泻可能与罕见的肝脏并发症相关，如肝T细胞淋巴瘤。由于许多乳糜泻患者没有明显的胃肠道症状，因此需要高度怀疑。诸如血清抗体检测等检测乳糜泻的简单方法有助于早期识别该疾病，从而预防该疾病的严重并发症。联合使用的IgG脱酰胺基谷蛋白抗体检测和IgA组织转谷氨酰胺酶抗体检测是疑似乳糜泻病例的极佳筛查检测方法。
