Liver manifestation of patients with celiac disease: A single center experience

Adeyinka Akinsanya; Iván A González

doi:10.1016/j.anndiagpath.2024.152327

Liver manifestation of patients with celiac disease: A single center experience

Ann Diagn Pathol. 2024 May 11:71:152327. doi: 10.1016/j.anndiagpath.2024.152327. Online ahead of print.

Authors

Adeyinka Akinsanya¹, Iván A González²

Affiliations

¹ Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, United States of America.
² Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, United States of America. Electronic address: iagonzal@iu.edu.

PMID: 38754356
DOI: 10.1016/j.anndiagpath.2024.152327

Abstract

Objectives: Characterize the clinicopathologic features of liver biopsies from patients with celiac disease (CD).

Methods: Single center, retrospective search for liver biopsies from patients with CD.

Results: 36 unique patients were included, median age of 46 years (range: 2-75), including 5 pediatric patients, with an overall female predominance (25, 69 %) but in in children a male predominance was seen (p = 0.023). Most cases (75 %) had an underlying condition including autoimmune hepatitis (AIH) (11 %), AIH/primary biliary cholangitis (PBC) overlap (3 %) and PBC (3 %). The median body mass index was 28, with 4 (11 %) underweight and 22 (61 %) overweight/obese patients. The most common histologic pattern was steatosis (18, 50 %), considered severe in 5 (14 %) and in 7 (19 %) regarded as steatohepatitis. The other histologic patterns included a nonspecific portal and/or lobular inflammation ("celiac hepatitis") in 9 cases (25 %), autoimmune hepatitis (3, 8 %), chronic cholestatic pattern (3, 8 %), chronic hepatitis (1, 3 %), acute lobular hepatitis (1, 3 %) and stablished cirrhosis (1, 3 %). Additionally, 2 of the cases with steatosis show cirrhosis.

Conclusions: The biopsy findings from patients with CD are heterogenous and in most represent a concomitant underlying disease, particularly metabolic dysfunction-associated steatotic liver disease. Additionally, CD injury should remain in the differential diagnosis in liver biopsies with a nonspecific portal and/or lobular inflammation.

Keywords: Celiac disease; Liver; Pathology; Steatosis.