Chronic Hepatitis Due to Gluten Enteropathy - a Case Report.
Folia Med (Plovdiv)
; 59(2): 228-231, 2017 Jun 01.
Article
em En
| MEDLINE
| ID: mdl-28704189
ABSTRACT
BACKGROUND:
Celiac disease is an immune-mediated enteropathy precipitated by exposure to dietary gluten in genetically predisposed individuals. CASE DESCRIPTION A 45-year-old Caucasian woman presented with severe iron-deficient anemia and mild elevation of liver enzymes. Upper endoscopy was done in the context of evaluation of anemia, which revealed reduced duodenal folds and mosaic pattern of the mucosa, but also grade II esophageal varices and portal hypertensive gastropathy. Duodenal biopsy showed total villous atrophy, diffuse mainly lymphocytic infiltrate, presence of intra-epithelial lymphocytes. Serology test confirmed celiac disease by the typical pattern of high titer positive IgA and IgG antibodies to tissue transglutaminase. Liver biopsy was performed for staging and etiological evaluation, because laboratory screening ruled out common viral, metabolic and autoimmune liver disease. Liver morphology was consistent with chronic hepatitis without findings for extensive fibrosis. Our patient had poor dietary compliance, so we failed to established improvement of liver enzymes and resolution of anemia during follow-up.CONCLUSIONS:
We would like to stress on the diverse clinical manifestations of celiac disease and the importance of serologic screening with antibodies to tissue transglutaminase in differential diagnosis of chronic liver disease.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Autoanticorpos
/
Doença Celíaca
/
Hepatite Autoimune
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Female
/
Humans
/
Middle aged
Idioma:
En
Revista:
Folia Med (Plovdiv)
Ano de publicação:
2017
Tipo de documento:
Article
País de afiliação:
Bulgária