Coeliac disease prevalent in patients with liver disorder

07 Jun 2023
Coeliac disease prevalent in patients with liver disorder

Coeliac disease (CeD) appears to be common in patients with cryptogenic cirrhosis or cryptogenic hypertransaminasaemia, suggests a study, noting that these individuals must be considered high-risk groups for CeD.

In this systematic review and meta-analysis, a team of investigators searched the databases of PubMed and Embase up to January 2022. They identified cross-sectional, case-control, and prospective cohort studies that performed serological tests or intestinal biopsy for CeD on patients with cryptogenic cirrhosis, all-cause cirrhosis, cryptogenic hypertransaminasaemia, and all-cause hypertransaminasaemia.

Pooled estimates of seroprevalence as well as the prevalence of biopsy-confirmed CeD in the four groups were then calculated.

A total of 6,871 articles were evaluated, but only 20 met the inclusion criteria and were included in three meta-analyses for cryptogenic cirrhosis, all-cause cirrhosis, and cryptogenic hypertransaminasaemia. The investigators conducted a qualitative review of four studies for the all-cause hypertransaminasaemia group instead of a meta-analysis due to significant differences in the studies.

The pooled prevalence of biopsy-confirmed CeD in cryptogenic cirrhosis was 4.6 percent (95 percent confidence interval [CI], 2.2‒7.5), while that in all-cause cirrhosis was only 0.8 percent (95 percent CI, 0‒3.4). Finally, the pooled prevalence of biopsy-confirmed CeD in cryptogenic hypertransaminasaemia was 5.7 percent (95 percent CI, 3.2‒8.8).

“While the prevalence of CeD in those with all-cause cirrhosis is similar to that in general population, it may be worth screening them for CeD because liver pathology has the potential for reversal in them,” the investigators said.

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