Adult celiac disease and hypertransaminasemia

OBJECTIVE: to determine the incidence of hypertransaminasemia in adult pati ents with celiac disease with or without relevant chronic liver disease, an d to evaluate the response after a gluten-free diet. PATIENTS AND METHODS: retrospective study of 20 cases of adult celiac disea se (> 14 years old at diagnosis). Patients were included in the study if th ey fulfilled the revised EPSGAN criteria. If laboratory tests of liver func tion revealed alterations, hepatitis B and C viral serology, thyroid hormon es, and use of alcohol and drugs were investigated, and liver ultrasound sc ans were done. Liver biopsy and endoscopic retrograde cholangiopancreatogra phy were done only in patients for whom these studies were considered neces sary. RESULTS: ten patients had hypertransaminasemia (50%), ascribed to benzodiaz epine use in 1 patient, chronic HCV hepatitis in 1, and celiac disease in 8 . In all of these last patients except 1 (benzodiazepine use), laboratory v alues returned to normal after 4-10 months on a gluten-free diet. CONCLUSIONS: celiac disease was frequently associated with hypertransaminas emia. In most patients transaminase levels returned to normal within 1 year after dietary gluten intake was restricted. If alterations in laboratory v alues persist, other causes that may be related (e.g., autoimmunity or tumo rs) or unrelated to celiac disease (e.g., virus) must be ruled out.