Serologic testing for celiac disease in young people with elevated transaminases

Background/aim: A cryptogenic elevation of transaminases is the most common hepatic manifestation in celiac disease (CD). In adult patients and pediatric patients with cryptogenic hypertransaminasemia, the prevalence of CD was 4% and 12%, respectively. However, there are no related data from China in this regard. We aimed to investigate the status of CD in young Chinese patients with elevated transaminases. Materials and methods: A total of 125 patients with elevated transaminases and 125 healthy individuals as controls with matched age and sex were involved in the study. Serum markers of hepatitis B were determined in patients with elevated transaminases. All subjects were screened for CD by testing serum IgA antitissue transglutaminase antibodies (anti-tTG IgA), and total serum IgA was determined in order to rule out IgA deficiency. Results: None of the subjects were seropositive to IgA anti-tTG antibodies. No association between CD and elevated transaminases was found. Hepatitis B viral infections were one of the main causes of raised transaminases. Conclusion: Before the exclusion of every known cause of raised transaminase levels, routine serological screening for CD should not be recommended for patients who only present elevated transaminases.

Serologic testing for celiac disease in young people with elevated transaminases

Background/aim: A cryptogenic elevation of transaminases is the most common hepatic manifestation in celiac disease (CD). In adult patients and pediatric patients with cryptogenic hypertransaminasemia, the prevalence of CD was 4% and 12%, respectively. However, there are no related data from China in this regard. We aimed to investigate the status of CD in young Chinese patients with elevated transaminases. Materials and methods: A total of 125 patients with elevated transaminases and 125 healthy individuals as controls with matched age and sex were involved in the study. Serum markers of hepatitis B were determined in patients with elevated transaminases. All subjects were screened for CD by testing serum IgA antitissue transglutaminase antibodies (anti-tTG IgA), and total serum IgA was determined in order to rule out IgA deficiency. Results: None of the subjects were seropositive to IgA anti-tTG antibodies. No association between CD and elevated transaminases was found. Hepatitis B viral infections were one of the main causes of raised transaminases. Conclusion: Before the exclusion of every known cause of raised transaminase levels, routine serological screening for CD should not be recommended for patients who only present elevated transaminases.

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  • 1. Lammers KM, Vasagar B, Fasano A. Definition of celiac disease and gluten sensitivity. In: Devi Rampertab S, Mullin GE, editors. Celiac Disease. 1st ed. New York, NY, USA: Springer; 2014. pp. 13–25.
  • 2. Green PH, Cellier C. Celiac disease. New Engl J Med 2007; 357: 1731–1743. 3. Zali MR, Nejad MR, Rostami K, Alavian SM. Liver complications in celiac disease. Hepat Mon 2011; 11: 333–341.
  • 4. Volta U, Franceschi LD, Lari F, Molinaro N, Zoli M, Bianchi FB. Coeliac disease hidden by cryptogenic hypertransaminasaemia. Lancet 1998; 352: 26–29.
  • 5. Vajro P, Paolella G, Maggiore G, Giordano G. Pediatric celiac disease, cryptogenic hypertransaminasemia, and autoimmune hepatitis. J Pediatr Gastr Nutr 2013; 56: 663–670.
  • 6. Sainsbury A, Sanders DS, Ford A. Meta-analysis: coeliac disease and hypertransaminasaemia. Aliment Pharm Ther 2011; 34: 33–40.
  • 7. Emami MH, Hashemi M, Kouhestani S, Taheri H, Karimi S. Should we look for celiac disease among all patients with liver function test abnormalities? Int J Prev Med 2012; 3: 167–172.
  • 8. Ludvigsson JF, Biagi F, Corazza GR. Epidemiology of celiac disease. In: Devi Rampertab S, Mullin GE, editors. Celiac Disease. 1st ed. New York, NY, USA: Springer; 2014. pp. 27–37.
  • 9. Cummins AG, Roberts-Thomson IC. Prevalence of celiac disease in the Asia–Pacific region. J Gastroen Hepatol 2009; 24: 1347–1351.
  • 10. Yuan J, Gao J, Li X, Liu F, Wijmenga C, Chen H, Gilissen LJ. The tip of the “celiac iceberg” in China: a systematic review and meta-analysis. PLoS One 2013; 8: e81151.
  • 11. Jiang L, Zhang B, Liu YS. Is adult celiac disease really uncommon in Chinese? J Zhejiang Univ Sci B 2009; 10: 168– 171.
  • 12. Wang XQ, Liu W, Mei H, Gao Y, Peng HM, Yuan L, Xu JJ. Celiac disease in children with diarrhea in 4 cities in China. J Pediatr Gastr Nutr 2011; 53: 368–370.
  • 13. Wu J, Xia B, von Blomberg B, Zhao C, Yang X, Crusius J, Peña A. Coeliac disease in China, a field waiting for exploration. Rev Esp Enferm Dig 2010; 102: 472–477.
  • 14. Wang H, Luo L, Kou J, Yuan A, Yang G, Wang M, Xia B. Serum screening of celiac disease in Chinese adults with diarrheapredominant irritable bowel syndrome in Hubei, China. Zhonghua Nei Ke Zha Zi 2013; 52: 38–41 (in Chinese with abstract in English).
  • 15. Department of Disease Control Ministry of Health PC. Chinese Adult Overweight and Obesity Prevention and Control Guidelines. 1st ed. Beijing, China: People’s Medical Publishing House Co., Ltd; 2006 (in Chinese).
  • 16. Zhang Y, Weng X. Infectious Diseases. 4th ed. Shanghai, China: Fudan University Press; 2009 (in Chinese).
  • 17. Pratt DS, Kaplan MM. Evaluation of abnormal liver-enzyme results in asymptomatic patients. New Engl J Med 2000; 342: 1266–1271.
  • 18. Oh RC, Hustead TR. Causes and evaluation of mildly elevated liver transaminase levels. Am Fam Physician 2011; 84: 1003– 1008.
  • 19. Sima H, Hekmatdoost A, Ghaziani T, Alavian SM, Mashayekh A, Zali M. The prevalence of celiac autoantibodies in hepatitis patients. Iran J Allergy Asthm 2010; 9: 157–162.
  • 20. Nau AL, Fayad L, Lazzarotto C, Shiozawa MBC, DantasCorrea EB, Schiavon LDL, Narciso-Schiavon JL. Prevalence and clinical features of celiac disease in patients with hepatitis B virus infection in Southern Brazil. Rev Soc Bras Med Trop 2013; 46: 397–402.
  • 21. Leonardi S, La Rosa M. Are hepatitis B virus and celiac disease linked? Hepat Mon 2010; 10: 173–175.
  • 22. Drastich P, Honsová E, Lodererová A, Jarešová M, Pekáriková A, Hoffmanová I, Tučková L, Tlaskalová-Hogenová H, Špičák J, Sánchez D. Celiac disease markers in patients with liver diseases: a single center large scale screening study. World J Gastroenterol 2012; 18: 6255–6262.
  • 23. Volta U, Granito A, De Franceschi L, Petrolini N, Bianchi F. Anti tissue transglutaminase antibodies as predictors of silent coeliac disease in patients with hypertransaminasaemia of unknown origin. Digest Liver Dis 2001; 33: 420–425.
  • 24. Bardella MT, Fraquelli M, Quatrini M, Molteni N, Bianchi P, Conte D. Prevalence of hypertransaminasemia in adul
  • 25. Vivas S, de Morales JMR, Martinez J, González MC, Martín S, Martín J, Cechini C, Olcoz JL. Human recombinant antitransglutaminase antibody testing is useful in the diagnosis of silent coeliac disease in a selected group of at-risk patients. Eur J Gastroenterol Hepat 2003; 15: 479–483.
  • 26. Liang X, Bi S, Yang W, Wang L, Cui G, Cui F, Zhang Y, Liu J, Gong X, Chen Y. Epidemiological serosurvey of hepatitis B in China--declining HBV prevalence due to hepatitis B vaccination. Vaccine 2009; 27: 6550–6557.
  • 27. Schwenger KJ, Allard JP. Clinical approaches to non-alcoholic fatty liver disease. World J Gastroenterol 2014; 20: 1712–1723.
  • 28. Zhang H, He SM, Sun J, Wang C, Jiang YF, Gu Q, Feng XW, Du B, Wang W, Shi XD. Prevalence and etiology of abnormal liver tests in an adult population in Jilin, China. Int J Mech Sci 2011; 8: 254–256.
  • 29. Llorente-Alonso M, Fernandez-Acenero M, Sebastian M. Gluten intolerance: sex-and age-related features. Can J Gastroenterol 2006; 20: 719–722.
  • 30. Bardella MT, Fredella C, Saladino V, Trovato C, Cesana BM, Quatrini M, Prampolini L. Gluten intolerance: gender-and age-related differences in symptoms. Scand J Gastroenterol 2005; 40: 15–19.
Turkish Journal of Medical Sciences-Cover
  • ISSN: 1300-0144
  • Yayın Aralığı: Yılda 6 Sayı
  • Yayıncı: TÜBİTAK
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