Should We Look for Celiac Disease among all Patients with Liver Function Test Abnormalities?

Background: celiac disease (cd) has been found in up to 10% ofthe patients presenting with unexplained abnormal liver functiontests (lft). as there is no precise data from our country in thisregard, we investigated the prevalence of cd in patients presentingwith abnormal lft.methods: from 2003 to 2008, we measured iga anti-tissuetransglutaminase (t-tg) antibody (with elisa technique) withinthe first-level screening steps for all patients presenting withabnormal lft to three outpatient gastroenterology clinics inisfahan, iran. all subjects with an iga anti-ttg antibody valueof > 10 ?/ml (seropositive) were undergone upper gastrointestinalendoscopy and duodenal biopsy. histopathological changes wereassessed according to the marsh classification. cd was defined asbeing seropositive with marsh i or above in histopathology andhaving a good response to gluten free diet (gfd).results: during the study, 224 patients were evaluated, out ofwhich, 10 patients (4.4%) were seropositive for cd. duodenalbiopsies were performed in eight patients and revealed six (2.7%)cases of marsh i or above (four marsh iiia, two marsh i), all ofthem had good response to gfd. the overall prevalence of cdamong patients with hypertransaminasemia, autoimmune hepatitis,and cryptogenic cirrhosis was determined as 10.7% (3/28), 3.4%(2/59), and 5.3% (1/19), respectively.conclusion: serological screening with iga anti-ttg antibodytest should be routinely performed in patients presenting withabnormal lft and especially those with chronic liver diseasesincluding hypertransaminasemia, autoimmune hepatitis, andcryptogenic cirrhosis.