An autoimmune disease refractory to immunosuppressive regimens: celiac disease diagnosed long after liver transplantation.
Pediatr Transplant
; 17(7): E156-60, 2013 Nov.
Article
em En
| MEDLINE
| ID: mdl-23962034
ABSTRACT
CD is defined as T-lymphocyte-mediated gluten sensitivity. Although CD is known to affect the small intestine, it is nonetheless a multisystem disorder. Liver involvement in CD may vary from isolated hypertransaminasemia to cirrhosis. Because CD is an inappropriate immune response to gluten proteins, strict gluten-free diet is the principal therapy, along with management of liver dysfunction. In patients who fail to respond to a gluten-free diet, immunosuppressive drugs may improve intestinal inflammatory activity in untreated CD. The present case report is of a 25-yr-old woman with diarrhea lasting several weeks. The patient had received a liver transplant 13 yr earlier, and presented with cryptogenic cirrhosis diagnosed as CD. This appears to be the first case of its kind in which a pediatric long-term liver transplant patient presents with diarrhea eventually diagnosed as CD whose diet included gluten, and who was treated by an immunosuppressive drug regimen. Because of the normalization of CD-related antibodies in the post-transplantation period without gluten restriction, CD should be part of a list of diagnostic possibilities in liver transplant patients presenting with diarrhea of unknown etiology.
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Texto completo:
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Doenças Autoimunes
/
Doença Celíaca
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Transplante de Fígado
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Imunossupressores
Tipo de estudo:
Diagnostic_studies
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Etiology_studies
Limite:
Adult
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Female
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Humans
Idioma:
En
Ano de publicação:
2013
Tipo de documento:
Article