Nodular regenerative hyperplasia of the liver in a patient with celiac disease

We present the case of dual adult celiac disease and liver disease with por tal hypertension (esophageal varices); a percutaneous liver biopsy was comp atible with nonspecific reactive hepatitis. Clinically, celiac disease was characterised by poor response to a gluten-free diet, with the development of a biochemical cholestasis and marked malnutrition. Our patient died of c erebral hemorrhage, at the age of 50 years, without associated risk factors . The necropsy demonstrated the existence of a nodular regenerative hyperpl asia of the liver, splenic atrophy, gelatinous transformation of the bone m arrow, and lymphocytic colitis. We discuss the different types of liver dis orders associated with celiac disease and the possible relation between nod ular regenerative hyperplasia and celiac disease, based on immunologic mech anisms.