SCREENING PATIENTS WITH CELIAC-DISEASE FOR PRIMARY BILIARY-CIRRHOSIS AND VICE-VERSA

Background: An association between celiac disease and primary biliary cirrhosis has been reported in a few eases, mainly as individual case reports. Objectives: To screen adult patients with celiac disease for primary biliary cirrhosis and patients with primary biliary cirrhosis for intestinal celiac involvement. Methods: The celiac group consisted of 336 adults (218 women and 118 men; mean age, 36 yr; range 18-74 yr ) with celiac disease diagnosed by serological and histological tests, 38 with newly diagnosed celiac disease and 298 with previously diagno sed celiac disease who were consuming a gluten-free diet. The mean fol low-up period was 6 yr (range, 1-16 yr). Liver function parameters and autoantibody levels were determined, and, when indicated, histologica l tests were performed. The biliary cirrhosis group consisted of 65 su bjects (58 women and seven men) (mean age, 59 yr; range, 35-67 yr) wit h primary biliary cirrhosis diagnosed 1-17 years previously (mean, 7 y r) on the basis of the usual biochemical, serological, and histologica l criteria. Antigliadin and antiendomysium antibody levels were determ ined, and two biopsy specimens from the distal duodenum obtained durin g endoscopy were evaluated. Results: In patients with celiac disease, impairment of liver function was frequently found at diagnosis (16 of 38, or 44%), but primary biliary cirrhosis was diagnosed in only one c ase. In patients with primary biliary cirrhosis, no cases of celiac di sease, as currently defined, were found. Conclusions: Our findings ind icate that celiac disease and primary biliary cirrhosis are rarely ass ociated and support the hypothesis that the intestinal lesions per se are not responsible for the liver disease.