Prevalence of IgA antibodies to endomysium and tissue transglutaminase in primary biliary cirrhosis

The association between celiac disease and primary biliary cirrhosis has be en described in several case reports and small screening studies, with vary ing prevalence rates. Stored sera from 378 patients with primary biliary ci rrhosis were tested for immunoglobulin (Ig) A endomysium and tissue transgl utaminase antibodies. Ten patients were positive for both antibodies (2.6%) ; five of these patients had had small bowel biopsies confirming celiac dis ease A further 44 patients (11.6%) had raised titres of IgA tissue transglu taminase antibody but were negative for IgA endomysium antibody. The increa sed prevalence of celiac-related antibodies in patients with primary biliar y cirrhosis suggests that the two conditions are associated although the re ason for the association remains unclear. Patients with primary biliary cir rhosis should be considered to be at high risk for celiac disease. Although liver biochemistry does not improve when these patients are fed a gluten-f ree diet, the complications of untreated celiac disease warrant the identif ication and treatment of the condition in this population.