[Liver involvement in celiac disease in children].

UNLABELLED

Celiac disease (CD) is an autoimmune systemic enteropathy triggered by gluten intake in patients with genetic susceptibility, characterized by clinic polymorphism: classic forms, mainly with digestive features, and atypical forms, liver involvement being a part of them. In present, any unknown cytolysis requires screening serologic determinations for CD.

AIMS

to assess the presence of liver manifestations in children diagnosed with CD, the outcome of liver function with gluten-free diet (GFD) and also to emphasize the importance of the immunological screening for CD in patients with unknown etiology liver dysfunctions.

MATERIAL AND METHODS

The trial was formed by 120 patients diagnosed with CD between January 2007 - December 2010 in 2nd and 3rd Pediatric Clinics of "Sf. Maria" Hospital Iaşi; liver function was assessed; viral hepatitis and autoimmune hepatitis markers were determined; all patients were given GFD, hepatoprotective agents and antivirals specific to each form of hepatitis; the transaminases level variation was followed in time.

RESULTS

12 of the CD diagnosed patients (10, 14%) had altered liver function at the onset of disease; the only abnormality was the increased transaminases level in 57, 14% of cases; HBsAg was found positive in 33, 33% (4 cases); liver biopsy in one patient evidenced steatosis. The study has shown that 4% of the patients with cryptogenetic hepatitis have a silent form of CD, the serologic screening for AGA, AEA, ATGA being essential for diagnosis.

CONCLUSIONS

we have to rule out CD in patients with liver disease of unknown etiology, before we consider it as "cryptogenetic"; occurrence of cytolysis in the absence of positive viral markers requires the assessment of screening tests for CD.