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World J Gastroenterol. May 21, 2015; 21(19): 5813-5822
Published online May 21, 2015. doi: 10.3748/wjg.v21.i19.5813
Liver involvement in pediatric celiac disease
Caterina Anania, Ester De Luca, Giovanna De Castro, Claudio Chiesa, Lucia Pacifico
Caterina Anania, Ester De Luca, Giovanna De Castro, Lucia Pacifico, Department of Pediatrics and Child Neuropsychiatry, Sapienza University of Rome, Rome, Viale Regina Elena, 324 00161 Rome, Italy
Claudio Chiesa, Institute of Translational Pharmacology, National Research Council, Via Fosso del Cavaliere, 100 00133 Rome, Italy
Author contributions: Anania C, Chiesa C and Pacifico L designed the study, analyzed the data and wrote the manuscript; De Castro G and De Luca E collected the data; all the authors participated in the critical review and in the final approval of the manuscript.
Conflict-of-interest: There are no potential conflicts of interest relevant to this article.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Lucia Pacifico, MD, Department of Pediatrics and Child Neuropsychiatry, Sapienza University of Rome, Rome, Viale Regina Elena, 324 00161 Rome, Italy. lucia.pacifico@uniroma1.it
Telephone: +39-6-49979215 Fax: +39-6-49979216
Received: January 22, 2015
Peer-review started: January 24, 2015
First decision: February 10, 2015
Revised: February 27, 2015
Accepted: April 17, 2015
Article in press: April 17, 2015
Published online: May 21, 2015
Abstract

Celiac disease (CD) is an intestinal inflammatory disease that manifests in genetically susceptible individuals when exposed to dietary gluten. It is a common chronic disorder, with a prevalence of 1% in Europe and North America. Although the disease primarily affects the gut, the clinical spectrum of CD is remarkably varied, and the disease can affect many extraintestinal organs and systems, including the liver. The hepatic dysfunction presenting in CD ranges from asymptomatic liver enzyme elevations or nonspecific reactive hepatitis (cryptogenic liver disorders), to chronic liver disease. In this article, we review the clinical presentations and possible mechanisms of CD-related liver injury to identify strategies for the diagnosis and treatment of these disorders in childhood.

Keywords: Celiac disease, Cryptogenic hypertransaminasemia, Autoimmune liver disease, End-stage liver disease, Fatty liver

Core tip: Celiac disease (CD) is increasingly reported in children who are symptomless or present atypical symptoms and signs. Liver abnormalities are common extraintestinal manifestations in patients with CD and range from mild hepatic injury to severe liver disease. Awareness of this may help clinicians to improve strategies for the diagnosis and treatment of these disorders in childhood.