A recent retrospective study (E Benelli et al. JPGN 2019; 68: 547-51) examines a large cohort of patients (=700) who were diagnosed with celiac disease (CD) from 2010-2016 and had available liver transaminases.
- ALT values >40 U/L were elevated in only 3.9% (27/700)
- Younger age (<4.27 years) correlated with a higher risk of liver involvement with OR 3.73
- Of these 27 patients with elevated ALT, 18 had adequate followup. All but 3 patients normalized ALT values after at least 1 year; of these, 1 was diagnosed with sclerosing cholangitis. In the other two, one was thought to be nonadherent with gluten-free diet and one had dropped ALT to 47 U/L.
- Thus, definitive autoimmune liver disease was identified in only one patient
My take: This study shows a lower rate of liver involvement than previous studies.
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