The Effects of Gluten-Free Diet on Hypertransaminasemia in Patients with Celiac Disease

Mostafa Alavi Moghaddam, Mohammad Rostami Nejad, Hamid Mohaghegh Shalmani, Kamran Rostami, Ehsan Nazemalhosseini Mojarad, David Aldulaimi, Mohammad Reza Zali


Background: Celiac disease (CD) is an immune mediated condition that leads to small bowel atrophy that resolves with a gluten free diet (GFD). Extra-intestinal manifestations of CD include hypertransaminasemia. In this study, the effects of a GFD on hypertransaminasemia in patients with newly diagnosed CD were studied.

Methods: Ninety eight new diagnosed consecutive patients with CD 40 males and 58 females) with mean age of 32 ± 17.1 were studied. All patients with CD were treated with a GFD. Patients with hypertransaminasemia, at diagnosis, had a cirrhosis screen performed. Patients with a negative cirrhosis screen were reviewed, 6 months after the introduction of a GFD, and serum levels of liver transaminases were measured again.

Results: Nine patients had hypertransaminasemia. One patient was Hepatitis B surface antigen positive and was excluded from this study. The 8 remaining patients had no obvious cause for the hypertransaminasemia. Mean (± SD) of baseline aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were 42.6 ± 16.5 IU/L (range: 16-66 IU/L) and 69.3 ± 9.3 IU/L (range: 52-81 IU/L). Six months after treatment with a GFD, mean AST and ALT levels decreased to 24.5 ± 5.1 IU/L (range: 18-31 IU/L) (P: 0.04) and 24.6 ± 6 IU/L (range: 17-32 IU/L) (P: 0.01), respectively. In 7 patients the hypertransaminasemia, at diagnosis had resolved.

Conclusions: This study provides further evidence that some patients with CD have a reversible hypertransaminasemia that resolves with a GFD.

Keywords: Celiac disease, gluten-free diet, hypertransaminasemia, liver

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