Changes in the liver in glutenic enteropathy

Abstract

Aim. To evaluate frequency of clinical manifestations, biochemical and morphological alterations characteristic of liver affection in patients with glutenic enteropathy (GEP) in correlation with GE duration and severity of malabsorption syndrome (MAS). Material and methods. 116 GEP patients have undergone clinico-laboratory examination, intestinoscopy with biopsy of jejunal mucosa, puncture biopsy of the liver with morphological examination of the specimens, ultrasonography of the liver. In addition, the immune status was assessed and tests for markers of hepatotropic viruses В and С were made. Results. Clinical symptoms, typical for hepatic lesion in GEP patients, such as yellowness of the skin and scleras, palmar erythema, vascular Stella and hepatomegaly were found in 7.2% cases. Hyperaminotransferasemia was detected in 48.4% of new cases of celiac disease, in 18.1% of patients on strict aglutenic diet. Aminotransferase hyperactivity detection was associated with severity of MAS. Morphological alterations in the liver in celiac disease are characterized by fat dystrophy, portal and periportal hepatitis, steatohepatitis or fibrosis. Combined therapy of celiac disease including strict aglutenic diet, correction of metabolic disturbances was not always effective in correction of metabolic processes in the liver. In new GEP cases early adequate therapy was most effective. Conclusion. The course of glutenic enteropathy is accompanied with clinicomorphological alterations in the liver. This necessitates use of drugs improving liver function.

Keywords

• glutenic enteropathy
• hepatic alterations
• hyperaminotransferasemia
• steatohepatitis