effects of gluten-free diet on hypertransaminasemia in patients with celiac disease

ABSTRACT

Celiac disease [CD] is an immune mediated condition that leads to small bowel atrophy that resolves with a gluten free diet [GFD]. Extra-intestinal manifestations of CD include hypertransaminasemia. In this study, the effects of a GFD on hypertransaminasemia in patients with newly diagnosed CD were studied. Ninety eight new diagnosed consecutive patients with CD 40 males and 58 females] with mean age of 32 +/- 17.1 were studied. All patients with CD were treated with a GFD. Patients with hypertransaminasemia, at diagnosis, had a cirrhosis screen performed. Patients with a negative cirrhosis screen were reviewed, 6 months after the introduction of a GFD, and serum levels of liver transaminases were measured again. Nine patients had hypertransaminasemia. One patient was Hepatitis B surface antigen positive and was excluded from this study. The 8 remaining patients had no obvious cause for the hypertransaminasemia. Mean [ +/- SD] of baseline aspartate aminotransferase [AST] and alanine aminotransferase [ALT] levels were 42.6 +/- 16.5 IU/L [range 16-66 IU/L] and 69.3 +/- 9.3 IU/L [range 52-81 IU/L]. Six months after treatment with a GFD, mean AST and ALT levels decreased to 24.5 +/- 5.1 IU/L [range 18-31 IU/L] [P 0.04] and 24.6 +/- 6 IU/L [range 17-32 IU/L] [P 0.01], respectively. In 7 patients the hypertransaminasemia, at diagnosis had resolved. This study provides further evidence that some patients with CD have a reversible hypertransaminasemia that resolves with a GFD