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Prevalence of celiac disease in cirrhosis and outcome of cirrhosis on a gluten free diet: a prospective study.
Wakim-Fleming, Jamile; Pagadala, Mangesh R; McCullough, Arthur J; Lopez, Rocio; Bennett, Ana E; Barnes, David S; Carey, William D.
Afiliação
  • Wakim-Fleming J; Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, OH, United States. Electronic address: Fleminj1@ccf.org.
  • Pagadala MR; Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, OH, United States.
  • McCullough AJ; Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, OH, United States.
  • Lopez R; Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, United States.
  • Bennett AE; Anatomic Pathology, Cleveland Clinic, Cleveland, OH, United States.
  • Barnes DS; Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, OH, United States.
  • Carey WD; Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, OH, United States.
J Hepatol ; 61(3): 558-63, 2014 Sep.
Article em En | MEDLINE | ID: mdl-24842303
BACKGROUND & AIMS: Current consensus suggests CD to be a multi-systemic disease that could affect any organ system including the liver. It remains under-diagnosed in the US and its prevalence and management in cirrhotic patients has not been studied. Our aim was (1) to estimate the prevalence of CD in cirrhosis, (2) to characterize cirrhotic patients with abnormal celiac serology and normal small bowel biopsy and (3) to evaluate the effect of a GFD on the liver. METHODS: A total of 204 consecutive patients with biopsy proven cirrhosis scheduled for an upper endoscopy (EGD) to assess and treat gastro-esophageal varices (GEV) at the Cleveland Clinic between 5/1/2008 and 5/30/2010 were enrolled in the study and followed for 2 years. RESULTS: CD affects 2.5% of cirrhotic patients and more than twice the prevalence in the general population. Abnormal EMA >1/10 and high hTTG levels >20 IU can be used to diagnose CD in cirrhosis. Sensitivities and specificities are 100% for EMA and 80% and 94% for hTTG, respectively. After a GFD, patients with CD showed a return to normal levels of their celiac serology, small bowel biopsy and liver enzyme abnormalities. CONCLUSIONS: CD is at least twice more common in cirrhotic patients than in the general population and GFD improves liver tests. CD can occur coincidentally with other liver disorders and screening may be warranted during the evaluation of patients with cirrhosis. Abnormal EMA and high hTTG levels can be used to diagnose CD in cirrhosis.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Doença Celíaca / Dieta Livre de Glúten / Cirrose Hepática Tipo de estudo: Diagnostic_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: J Hepatol Assunto da revista: GASTROENTEROLOGIA Ano de publicação: 2014 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Doença Celíaca / Dieta Livre de Glúten / Cirrose Hepática Tipo de estudo: Diagnostic_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: J Hepatol Assunto da revista: GASTROENTEROLOGIA Ano de publicação: 2014 Tipo de documento: Article