eISSN: 2449-8238
ISSN: 2392-1099
Clinical and Experimental Hepatology
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vol. 7
Original paper

Liver function changes following the introduction of a gluten-free diet in patients with celiac disease

Omar I. Saadah
1, 2
Ammar Khayat
2, 3
Ohood Abusharifah
Meshari A. Alaifan
1, 2
Naglaa M. Kamal
5, 6
Yagoub Bin-Taleb
Bakr H. Alhussaini
1, 2

Department of Pediatrics, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
Pediatric Gastroenterology Unit, Department of Paediatrics, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
Department of Pediatrics, College of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
Department of Pediatrics, Maternity and Children Hospital Abha, Saudi Arabia
Department of Pediatrics, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt
Department of Pediatrics, Alhada Armed Forces Hospital, Taif, Saudi Arabia
Clin Exp HEPATOL 2021; 7, 4: 415-421
Online publish date: 2021/12/23
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Disturbance in liver enzymes is a well-described observation in patients with celiac disease (CD). We aim to describe the prevalence of all liver function abnormalities in CD and assess their response to a gluten-free diet (GFD).

Material and methods
This is a retrospective cross-sectional study of all CD patients diagnosed from 2007 to 2020 in King Abdulaziz University Hospital, Jeddah. Demographic, biochemical, and histologic patient data were collected.

The study included 132 patients with CD. The median age was 9.5 years (range, 1-18 years). Males constituted 56.1% (n = 74) of the whole cohort. The most common associated morbidities were type 1 diabetes (33%), thyroid disease (15.7%), and Down syndrome (7.6%). Ninety-seven percent of patients were determined to have a severe form of CD (Marsh score 3). Aspartate aminotransferase (AST) was high in 38 patients (28.8%), while alanine aminotransferase (ALT) was high in 10 (7.6%). Two patients (1.5%) had elevated g-glutamyl transferase (GGT) levels, and 2 patients (1.5%) had elevated AST, ALT, and GGT levels. Albumin levels were low in 29 patients (22%), while bilirubin levels were elevated in 1 patient. Introduction of a GFD resulted in improvement in ALT levels at 6 months, and improvement in albumin levels both after 6 months and 12 months.

Transaminase and albumin disturbances are frequently found in CD, with the most common abnormality being elevated AST. A decreased ALT level is the most pronounced response to a GFD.


celiac disease, hepatitis, transaminases, liver, child, Saudi Arabia

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