Objective: It is well known that there are different rates of liver damage in celiac disease (CD). A wide spectrum of cases has been reported, ranging from asymptomatic transaminase elevation to cirrhosis. In this study, we investigated the frequency and clinical features of liver stress in children diagnosed with CD in our department.
Methods: Patients who were aged 1-18, serologically and histologically diagnosed as having CD and followed up were retrospectively included. Medical history, physical examination, serum anti-tissue transglutaminase and anti-endomysium antibodies, duodenal histology, liver function tests and imaging findings were evaluated.
Results: One hundred and eleven patients were included in the study. Of the patients, 74 were girls (64%) and 40 were boys (36%), and the mean age of admission was 7.1±4.3 years (1-18 years). The follow-up period was 3.5±4.4 (1-16) years. At diagnosis, alanine aminotransferase (ALT) was elevated in 5 (4.5%) of the 111 patients, and at follow-up, 3 patients were found to have lower levels that returned to the normal range. Elevation of gamma-glutamyl transferase (GGT) (3.7%) was found in 4 patients. Sclerosing cholangitis was diagnosed by liver biopsy in 2 patients with elevated GGT. Abdominal ultrasonography (USG) was performed in 50 (45%) patients. Hepatomegaly was found in 4 (3.6%) of these 50 patients and biliar dilatation in 2 (1.8%) patients. Abdominal USG also revealed hepatomegaly in 4 patients, without elevation in GGT and ALT levels.
Conclusion: We found 8% liver-related findings at the time of diagnosis in children with CD. No new liver effects were observed in 29% of patients followed up for five years.