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World J Gastroenterol. Feb 7, 2017; 23(5): 776-791
Published online Feb 7, 2017. doi: 10.3748/wjg.v23.i5.776
To screen or not to screen? Celiac antibodies in liver diseases
Janaína Luz Narciso-Schiavon, Leonardo Lucca Schiavon
Janaína Luz Narciso-Schiavon, Leonardo Lucca Schiavon, Department of Internal Medicine, Division of Gastroenterology, Federal University of Santa Catarina, Santa Catarina 88040-900, Brazil
Author contributions: All authors contributed to the writing, analysing and revision of the manuscript.
Conflict-of-interest statement: None declared.
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:
Correspondence to: Janaína Luz Narciso-Schiavon, MD, PhD, Department of Internal Medicine, Division of Gastroenterology, Federal University of Santa Catarina, R. Prof. Ma Flora Pausewang s/no, 3º andar, Trindade, Florianópolis, Santa Catarina 88040-900, Brazil.
Telephone: +55-48-37219149 Fax: +55-48-37219014
Received: September 27, 2016
Peer-review started: September 28, 2016
First decision: November 9, 2016
Revised: November 28, 2016
Accepted: December 8, 2016
Article in press: December 8, 2016
Published online: February 7, 2017

Celiac disease (CD) is a systemic immune-mediated disorder triggered by dietary gluten in genetically predisposed individuals. The typical symptoms are anemia, diarrhea, fatigue, weight loss, and abdominal pain. CD has been reported in patients with primary sclerosing cholangitis, primary biliary cholangitis, autoimmune hepatitis, aminotransferase elevations, nonalcoholic fatty liver disease, hepatitis B, hepatitis C, portal hypertension and liver cirrhosis. We evaluate recommendations for active screening for CD in patients with liver diseases, and the effect of a gluten-free diet in these different settings. Active screening for CD is recommended in patients with liver diseases, particularly in those with autoimmune disorders, steatosis in the absence of metabolic syndrome, noncirrhotic intrahepatic portal hypertension, cryptogenic cirrhosis, and in the context of liver transplantation. In hepatitis C, diagnosis of CD can be important as a relative contraindication to interferon use. Gluten-free diet ameliorates the symptoms associated with CD; however, the associated liver disease may improve, remain the same, or progress.

Keywords: Celiac disease, Cholangitis, Sclerosing, Liver cirrhosis, Biliary, Hypertension, Portal, Hepatitis, Autoimmune

Core tip: Liver involvement in celiac disease (CD) has been reported for more than four decades. However, CD antibodies are seldom investigated by clinicians in routine hepatology consultations. In this article, we perform extensive literature review on liver and CD and evaluate if one should screen for celiac antibodies in various liver diseases and clinical settings.