DOI: 10.36347/sjams.2017.v05i02.031

Pages: 457-464

Celiac disease is a chronic immune-mediated disorder of the small intestine induced commonly by dietary wheat, barley and rye. It may coexist with autoimmune liver disorders such as autoimmune hepatitis, primary biliary cirrhosis, and primary sclerosing cholangitis. Our study revealed: 1) Isolated hyper transaminasemia with nonspecific histologic changes on a liver biopsy is the commonest hepatic presentation. 2) Liver function test abnormalities affect patients with classical CD or may be the sole presentation of atypical CD. 3) The most common age of presentation was 5 – 10 years with mean age of presentation of 9.47 years.4) There was male predominance with 1.63:1. M: F ratio 5) In the younger children <5 years of age, diarrhea was the most common presenting symptom whereas in the older children i.e. >10 years failure to thrive was the commonest presenting symptom.6) Transaminases were raised in (37.93%) cases. The rise in transaminases was less than 2 times upper limit of normal in 9 cases. 7) After 6 months of gluten free diet, ALT & AST came to be normal in 8 (72.72%) patients while in 3(27.27%) patients, the enzymes declined but were still higher than normal. Our observations suggest that elevated transaminase is common in patients with Celiac disease but recover on gluten free diet. 8)None of the patients had deranged bilirubin.9)Institution of gluten free diet resulted in dramatic clinical improvement with disappearance of GI symptoms like loose stools, pain abdomen and abdominal distension , improvement in appetite, weight and height gain. There was a significant weight and height gain of 4.49 ± 2.32 Kg and 4.61± 2.72 cm on 6 months of gluten free diet.10)Anemia was seen in 23 (88.46%) cases. 9(31.03%) had severe anemia(Hb<8 g/dl), 6 (20.69%) had moderate anemia (Hb 8-10 g/dl) and 8 (27.58%) had mild anemia(Hb 10-12 g/dl).