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Celiac sprue: another autoimmune syndrome associated with hepatitis C.

Abstract

OBJECTIVE

Celiac sprue is being diagnosed with increasing frequency by screening individuals with epidemiologically associated autoimmune syndromes. We sought to test our hypothesis that hepatitis C also may predispose to celiac sprue because it can trigger autoimmune reactions.

METHODS

Two hundred fifty-nine consecutively evaluated patients with chronic hepatitis C infection, 59 with autoimmune liver disease, 137 with other hepatic diseases, 356 with various GI syndromes, and 221 normal volunteers underwent serologic screening for celiac sprue. Patients with antigliadin, antiendomysial, and antitissue transglutaminase antibodies in serum underwent duodenoscopy and biopsy.

RESULTS

There was a statistically significantly higher prevalence of antigliadin antibody in all groups of patients with liver disease compared with GI controls and normal controls. However, only patients with hepatitis C (n = 3; 1.2%) or autoimmune liver disease (n = 2; 3.4%) had antiendomysial/antitissue transglutaminase antibody in serum. One of 221 normal volunteers (0.4%) was antigliadin, antiendomysial, and antitissue transglutaminase positive; this individual also was found to have hepatitis C (previously undiagnosed). Each of these six individuals had mild intestinal symptoms, duodenal histopathology consistent with celiac sprue, and the celiac-associated HLA-DQ2 allele. Five of the six followed a prescribed gluten-free diet and experienced symptomatic improvement.

CONCLUSION

Celiac sprue is epidemiologically associated with chronic hepatitis C infection and with autoimmune liver disease. Because hepatitis C is much more frequently encountered than autoimmune liver disease, hepatitis C appears to be the most common hepatic disease associated with the development of celiac sprue.

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  • Authors+Show Affiliations

    ,

    The Intestinal Health Institute, Dallas, Texas 75357, USA.

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    Source

    MeSH

    Adult
    Aged
    Autoimmune Diseases
    Biopsy, Needle
    Case-Control Studies
    Celiac Disease
    Chi-Square Distribution
    Cohort Studies
    Comorbidity
    Female
    Hepatitis C, Chronic
    Humans
    Liver Cirrhosis
    Male
    Middle Aged
    Prevalence
    Probability
    Prognosis
    Risk Assessment
    Risk Factors
    Serologic Tests
    Syndrome

    Pub Type(s)

    Comparative Study
    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    11197243

    Citation

    Fine, K D., et al. "Celiac Sprue: Another Autoimmune Syndrome Associated With Hepatitis C." The American Journal of Gastroenterology, vol. 96, no. 1, 2001, pp. 138-45.
    Fine KD, Ogunji F, Saloum Y, et al. Celiac sprue: another autoimmune syndrome associated with hepatitis C. Am J Gastroenterol. 2001;96(1):138-45.
    Fine, K. D., Ogunji, F., Saloum, Y., Beharry, S., Crippin, J., & Weinstein, J. (2001). Celiac sprue: another autoimmune syndrome associated with hepatitis C. The American Journal of Gastroenterology, 96(1), pp. 138-45.
    Fine KD, et al. Celiac Sprue: Another Autoimmune Syndrome Associated With Hepatitis C. Am J Gastroenterol. 2001;96(1):138-45. PubMed PMID: 11197243.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Celiac sprue: another autoimmune syndrome associated with hepatitis C. AU - Fine,K D, AU - Ogunji,F, AU - Saloum,Y, AU - Beharry,S, AU - Crippin,J, AU - Weinstein,J, PY - 2001/2/24/pubmed PY - 2001/3/3/medline PY - 2001/2/24/entrez SP - 138 EP - 45 JF - The American journal of gastroenterology JO - Am. J. Gastroenterol. VL - 96 IS - 1 N2 - OBJECTIVE: Celiac sprue is being diagnosed with increasing frequency by screening individuals with epidemiologically associated autoimmune syndromes. We sought to test our hypothesis that hepatitis C also may predispose to celiac sprue because it can trigger autoimmune reactions. METHODS: Two hundred fifty-nine consecutively evaluated patients with chronic hepatitis C infection, 59 with autoimmune liver disease, 137 with other hepatic diseases, 356 with various GI syndromes, and 221 normal volunteers underwent serologic screening for celiac sprue. Patients with antigliadin, antiendomysial, and antitissue transglutaminase antibodies in serum underwent duodenoscopy and biopsy. RESULTS: There was a statistically significantly higher prevalence of antigliadin antibody in all groups of patients with liver disease compared with GI controls and normal controls. However, only patients with hepatitis C (n = 3; 1.2%) or autoimmune liver disease (n = 2; 3.4%) had antiendomysial/antitissue transglutaminase antibody in serum. One of 221 normal volunteers (0.4%) was antigliadin, antiendomysial, and antitissue transglutaminase positive; this individual also was found to have hepatitis C (previously undiagnosed). Each of these six individuals had mild intestinal symptoms, duodenal histopathology consistent with celiac sprue, and the celiac-associated HLA-DQ2 allele. Five of the six followed a prescribed gluten-free diet and experienced symptomatic improvement. CONCLUSION: Celiac sprue is epidemiologically associated with chronic hepatitis C infection and with autoimmune liver disease. Because hepatitis C is much more frequently encountered than autoimmune liver disease, hepatitis C appears to be the most common hepatic disease associated with the development of celiac sprue. SN - 0002-9270 UR - https://www.unboundmedicine.com/medline/citation/11197243/Celiac_sprue:_another_autoimmune_syndrome_associated_with_hepatitis_C_ L2 - http://Insights.ovid.com/pubmed?pmid=11197243 DB - PRIME DP - Unbound Medicine ER -