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Paper Information

Journal:   ARCHIVES OF IRANIAN MEDICINE   NOVEMBER 2013 , Volume 16 , Number 11; Page(s) 683 To 685.
 
Paper: 

FULMINANT TYPE 1 AUTOIMMUNE HEPATITIS IN A RECENTLY DIAGNOSED CELIAC DISEASE PATIENT (CASE REPORT)

 
 
Author(s):  VOLTA UMBERTO*, ROSTAMI KAMRAN, TOVOLI FRANCESCO, CAIO GIACOMO, MASI CHIARA, RUGGERI EUGENIO, CACCIARI GIULIA, ISABELLA BON, GIORGIO ROBERTO DE
 
* DEPARTMENT OF MEDICAL AND SURGICAL SCIENCES, ST.ORSOLA-MALPIGHI HOSPITAL, UNIVERSITY OF BOLOGNA, VIA MASSARENTI, 940138 - BOLOGNA, ITALY
 
Abstract: 

Celiac disease (CD) is a small intestine immune-mediated disorder triggered by gluten ingestion in genetically predisposed patients. This condition can also affect many extraintestinal tissues, including the liver.
We report a patient presenting with a marked increase of transaminases at diagnosis of CD. The immune markers for autoimmune hepatitis (AIH) were negative. Following a few months of a strict gluten-free diet (GFD), aminotransferase levels decreased significantly (<2.5x U/L). The response to GFD suggested that the liver damage was due to a gluten-dependent celiac hepatitis, the most common liver abnormality in CD. Despite the fact that the patient never stopped the GFD, yet, in a few months, the aminotransferase levels raise again to high values (>50x U/L). At this time, the liver autoantibodies turned to be positive thus confirming the development of a type 1 AIH. The hepatic damage progressed to a late onset liver failure requiring liver transplantation.

 
Keyword(s): ANTINUCLEAR ANTIBODIES, ANTISMOOTH MUSCLE ANTIBODIES, AUTOIMMUNE HEPATITIS, CELIAC DISEASE, LIVER TRANSPLANTATION
 
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