Tags

Type your tag names separated by a space and hit enter

Anti-tissue transglutaminase antibodies in patients with abnormal liver tests: is it always coeliac disease?
Am J Gastroenterol 2005; 100(11):2472-7AJ

Abstract

BACKGROUND

Coeliac disease (CD) is found in 5-10% of patients with chronically abnormal liver tests and no obvious cause of liver disease. In this population the efficacy of screening for CD by anti-tissue transglutaminase (anti-tTG) may be impaired by the high rate of positive anti-tTG found in chronic liver disease.

AIMS

To evaluate the prevalence of coeliac disease and the role of anti-tTG in patients with non-viral, non-autoimmune chronic and no obvious cause of liver damage.

METHODS

Out of 2,512 consecutive patients with abnormal liver tests, 168 (118 men, 50 women; mean age 40.7 +/- 12.6 years) were defined, on the basis of clinical data and liver biopsy, as NAFLD or cryptogenic chronic hepatitis. All were tested by recombinant IgA and IgG anti-tissue transglutaminase. Patients with a positive serology underwent endoscopy with duodenal biopsies.

RESULTS

NAFLD was diagnosed in 121 patients, in 6 associated with cirrhosis, while 47 patients were considered as cryptogenic hepatitis in the absence of steatosis. Anti-tTG were positive in 20/168 patients (3 IgA alone; 11 IgG alone; 6 both IgA and IgG). Coeliac disease was found at endoscopy and confirmed by histopathology only in the 6 patients (3.6%) with both IgA and IgG anti-tTG positivity. Four of the patients with CD had NAFLD (3.3%), in 2 of them associated with cirrhosis; while 2 of those with cryptogenic hepatitis (4.2%) had CD.

CONCLUSIONS

The prevalence of CD in patients with chronically abnormal liver tests of unexplained etiology is 4%, with no relation with the degree of liver steatosis. Screening should be done by testing for IgA and IgG antibodies and then evaluating by endoscopy and biopsy only patients positive for both.

Authors+Show Affiliations

University of Palermo, Gastroenterology and Hepatology Unit, Palermo, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

16279902

Citation

Lo Iacono, Oreste, et al. "Anti-tissue Transglutaminase Antibodies in Patients With Abnormal Liver Tests: Is It Always Coeliac Disease?" The American Journal of Gastroenterology, vol. 100, no. 11, 2005, pp. 2472-7.
Lo Iacono O, Petta S, Venezia G, et al. Anti-tissue transglutaminase antibodies in patients with abnormal liver tests: is it always coeliac disease? Am J Gastroenterol. 2005;100(11):2472-7.
Lo Iacono, O., Petta, S., Venezia, G., Di Marco, V., Tarantino, G., Barbaria, F., ... Craxì, A. (2005). Anti-tissue transglutaminase antibodies in patients with abnormal liver tests: is it always coeliac disease? The American Journal of Gastroenterology, 100(11), pp. 2472-7.
Lo Iacono O, et al. Anti-tissue Transglutaminase Antibodies in Patients With Abnormal Liver Tests: Is It Always Coeliac Disease. Am J Gastroenterol. 2005;100(11):2472-7. PubMed PMID: 16279902.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Anti-tissue transglutaminase antibodies in patients with abnormal liver tests: is it always coeliac disease? AU - Lo Iacono,Oreste, AU - Petta,Salvatore, AU - Venezia,Giovanna, AU - Di Marco,Vito, AU - Tarantino,Giuseppe, AU - Barbaria,Francesco, AU - Mineo,Claudia, AU - De Lisi,Stefania, AU - Almasio,Piero Luigi, AU - Craxì,Antonio, PY - 2005/11/11/pubmed PY - 2005/12/21/medline PY - 2005/11/11/entrez SP - 2472 EP - 7 JF - The American journal of gastroenterology JO - Am. J. Gastroenterol. VL - 100 IS - 11 N2 - BACKGROUND: Coeliac disease (CD) is found in 5-10% of patients with chronically abnormal liver tests and no obvious cause of liver disease. In this population the efficacy of screening for CD by anti-tissue transglutaminase (anti-tTG) may be impaired by the high rate of positive anti-tTG found in chronic liver disease. AIMS: To evaluate the prevalence of coeliac disease and the role of anti-tTG in patients with non-viral, non-autoimmune chronic and no obvious cause of liver damage. METHODS: Out of 2,512 consecutive patients with abnormal liver tests, 168 (118 men, 50 women; mean age 40.7 +/- 12.6 years) were defined, on the basis of clinical data and liver biopsy, as NAFLD or cryptogenic chronic hepatitis. All were tested by recombinant IgA and IgG anti-tissue transglutaminase. Patients with a positive serology underwent endoscopy with duodenal biopsies. RESULTS: NAFLD was diagnosed in 121 patients, in 6 associated with cirrhosis, while 47 patients were considered as cryptogenic hepatitis in the absence of steatosis. Anti-tTG were positive in 20/168 patients (3 IgA alone; 11 IgG alone; 6 both IgA and IgG). Coeliac disease was found at endoscopy and confirmed by histopathology only in the 6 patients (3.6%) with both IgA and IgG anti-tTG positivity. Four of the patients with CD had NAFLD (3.3%), in 2 of them associated with cirrhosis; while 2 of those with cryptogenic hepatitis (4.2%) had CD. CONCLUSIONS: The prevalence of CD in patients with chronically abnormal liver tests of unexplained etiology is 4%, with no relation with the degree of liver steatosis. Screening should be done by testing for IgA and IgG antibodies and then evaluating by endoscopy and biopsy only patients positive for both. SN - 0002-9270 UR - https://www.unboundmedicine.com/medline/citation/16279902/Anti_tissue_transglutaminase_antibodies_in_patients_with_abnormal_liver_tests:_is_it_always_coeliac_disease L2 - http://Insights.ovid.com/pubmed?pmid=16279902 DB - PRIME DP - Unbound Medicine ER -