The prevalence of liver function abnormalities in pediatric Celiac disease patients and its relation with intestinal biopsy findings

Abnormal liver function tests and liver damage are seen fre- quently with celiac disease. However, the pathogenesis of liver functions abnormality is not clearly understood. The aim of this study was to determine the frequency of abnormal liver functions in children with celiac disease and its relation with anthropomet- ric measurements and severity of intestinal damage. Patients and methods : Twenty seven patients with celiac disease were included in the study. Anthropometric and laboratory exam- inations and intestinal biopsies were performed in all the patients. Mucosal lesions were classified according to the Marsh classifica- tion. Villous area, crypt height and mitotic count were measured morphometrically for all biopsy samples. Results : The mean age of patients was 6 ± 5 years on admis- sion. Alanine aminotransferase levels were normal (group 1) or elevated (group 2) in 20 and 7 patients, respectively. The mean ala- nine aminotransferase levels were 22.0 ± 7.2 in group 1 and 70.5 ± 31.1 U/L in group 2 patients, (p < 0.001). Complaints, mean age, height for age, weight for height, serum albumin level, villous area, crypt height and mitotic count were not significantly different between the two groups. Similarly, the ratio of Marsh classifica- tion was not significantly different between the two groups. All patients were given a gluten-free diet. Serum aminotransferase values returned to normal after 7.4 ± 2.7 months of a gluten-free diet. Conclusion : Abnormalities of liver functions are frequently seen in paediatric celiac disease patients. These abnormalities are not correlated with malnutrition and severity of intestinal mucos- al lesions. Liver enzyme activities return to normal levels in a few months after gluten-free diet (Acta gastroenterol. belg., 2005, 68, 424-427).