Liver Abnormalities in Celiac Disease
Liver Abnormalities in Celiac Disease
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DOI：
10.1016/s1542-3565(03)00313-6
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发表时间：
2004-02-01
影响因子：
12.6
通讯作者：
Swain, Mark
中科院分区：
文献类型：
--
作者：
Abdo, Ayman;Meddings, Jonathan;Swain, Mark
乳糜泻是指小肠对谷蛋白不耐受。虽然大多数有症状的患者都有与胃肠道有关的症状，但也有许多肠外表现。广泛的肝胆疾病已被描述，包括无症状的肝酶水平升高，非特异性肝炎，非酒精性脂肪性肝病，自身免疫性和胆汁淤积性肝病。此外，乳糜泻可能是肝酶水平升高的根本原因。由于大多数患者没有明显的胃肠道症状，因此需要高度怀疑。此外，在大多数患者中，肝酶水平会在无麸质饮食中恢复正常。我们回顾了有关与乳糜泻相关的肝脏异常的文献。我们还提出了一种调查和管理这些患者的方法。
Celiac disease is an intolerance of the small bowel to gluten. Although most symptomatic patients have symptoms related to the gastrointestinal tract, many extraintestinal manifestations have been described. A wide spectrum of hepatobiliary diseases have been described, including asymptomatic elevations of liver enzyme levels, nonspecific hepatitis, nonalcoholic fatty liver disease, and autoimmune and cholestatic liver disease. In addition, celiac disease may be the underlying cause of unexplained elevations of liver enzyme levels. Because most patients do not have overt gastrointestinal symptoms, a high index of suspicion is required. Moreover, in the majority of patients, liver enzyme levels will normalize on a gluten-free diet. We review the literature pertaining to hepatic abnormalities that may be seen in association with celiac disease. We also suggest an approach to the investigation and management of these patients.