Singh Prashant, Agnihotri Abhishek, Jindal Gaurav, Sharma Piyush Kumar, Sharma Minakshi, Das Prasenjit, Gupta Datta, Makharia Govind K
Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110 029, India.
Indian J Gastroenterol. 2013 Nov;32(6):404-8. doi: 10.1007/s12664-013-0352-z. Epub 2013 Aug 7.
Celiac disease is a multisystem disease, and the liver is affected in a subset of patients. We herein present a case series of 25 patients with celiac disease who had evidence of cirrhosis of the liver. We retrospectively reviewed the case records of patients with celiac disease having concomitant cirrhosis. The diagnosis of celiac disease was made on the basis of the modified European Society of Pediatric Gastroenterology, Hepatology, and Nutrition criteria. Of 25 patients (nine males; mean age 28.8 ± 16.6 years) with celiac disease and cirrhosis, 17 patients presented predominantly with cirrhosis, while 8 presented primarily with celiac disease. Five patients had known cause of cirrhosis (autoimmune hepatitis, three; PBC, one; hepatic venous outflow tract obstruction, one); the remaining 20 were cryptogenic. Gluten-free diet led to improvement in diarrhea and anemia and to a better control of ascites and other features of liver failure. Some patients with cryptogenic cirrhosis have coexistent celiac disease, and they show response to gluten-free diet. Patients with cryptogenic cirrhosis should be screened for celiac disease.
乳糜泻是一种多系统疾病，部分患者的肝脏会受到影响。我们在此呈现一组25例患有乳糜泻且有肝硬化证据的患者病例。我们回顾性分析了伴有肝硬化的乳糜泻患者的病例记录。乳糜泻的诊断依据改良的欧洲儿科胃肠病学、肝病学和营养学会标准。在25例（9例男性；平均年龄28.8±16.6岁）患有乳糜泻和肝硬化的患者中，17例主要表现为肝硬化，8例主要表现为乳糜泻。5例患者有已知的肝硬化病因（自身免疫性肝炎3例；原发性胆汁性胆管炎1例；肝静脉流出道梗阻1例）；其余20例为隐源性。无麸质饮食使腹泻和贫血得到改善，腹水及其他肝功能衰竭特征得到更好控制。一些隐源性肝硬化患者同时患有乳糜泻，且他们对无麸质饮食有反应。隐源性肝硬化患者应筛查是否患有乳糜泻。
