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Tanwar A, Gupta GK, Chauhan V, et al. Celiac Disease and Portal Hypertension: A Causal Association or Just a Coincidence?. J Clin Exp Hepatol. 2019;10(4):290-295doi: 10.1016/j.jceh.2019.11.005.
Tanwar, A., Gupta, G. K., Chauhan, V., Sharma, D., Jain, M. K., Bhardwaj, H., Jhajharia, A., & Nijhawan, S. (2020). Celiac Disease and Portal Hypertension: A Causal Association or Just a Coincidence?. Journal of clinical and experimental hepatology, 10(4), 290-295. https://doi.org/10.1016/j.jceh.2019.11.005
Tanwar, Amit, et al. "Celiac Disease and Portal Hypertension: A Causal Association or Just a Coincidence?." Journal of clinical and experimental hepatology vol. 10,4 (2020): 290-295. doi: https://doi.org/10.1016/j.jceh.2019.11.005
Tanwar A, Gupta GK, Chauhan V, Sharma D, Jain MK, Bhardwaj H, Jhajharia A, Nijhawan S. Celiac Disease and Portal Hypertension: A Causal Association or Just a Coincidence?. J Clin Exp Hepatol. 2020 Jul-Aug;10(4):290-295. doi: 10.1016/j.jceh.2019.11.005. Epub 2019 Nov 22. PMID: 32655231; PMCID: PMC7335706.
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J Clin Exp Hepatol. 2020 Jul-Aug;10(4):290-295. doi: 10.1016/j.jceh.2019.11.005. Epub 2019 Nov 22.

Celiac Disease and Portal Hypertension: A Causal Association or Just a Coincidence?.

Journal of clinical and experimental hepatology

Amit Tanwar, Gaurav K Gupta, Virender Chauhan, Deepak Sharma, Mukesh K Jain, Hemendra Bhardwaj, Ashok Jhajharia, Sandeep Nijhawan

Affiliations

  1. Department of Gastroenterology, SMS Medical College and Hospital, Jaipur, India.

PMID: 32655231 PMCID: PMC7335706 DOI: 10.1016/j.jceh.2019.11.005

Abstract

INTRODUCTION: Celiac disease (CD) has been linked to portal hypertension (PHT) of varied etiology, but the causality association has never been proved. We aim to study the prevalence of CD in patients of PHT of different etiology.

METHODS: A prospective observational study was conducted from June 2017 to December 2018 involving all the cases of PHT of varied etiology. Consecutive patients of PHT with chronic liver disease (CLD) of defined etiology like ethanol, viral hepatitis (B or C), Budd-Chiari syndrome (BCS), autoimmune-related cirrhosis, and cryptogenic CLD (cCLD) (group A) and those with noncirrhotic PHT (NCPHT), which included noncirrhotic portal fibrosis (NCPF) and extrahepatic portal vein obstruction (EHPVO) (group B), were screened for CD by IgA anti-tTG antibody followed by duodenal biopsy in serology-positive patients.

RESULTS: Out of a total of 464 patients, group A constituted 382 patients, CLD related to ethanol (155), cCLD (147), hepatitis B (42), hepatitis C (21), autoimmune (10), and BCS (7), whereas 82 patients were in group B with NCPF (64) and EHPVO (18). Total 29 patients were diagnosed with CD in both groups, 17 in group A (4.5%) and 12 in group B (14.6%). In group A, 13 patients with cCLD, two with HBV-related CLD, one with BCS, and one with autoimmune-related CLD were concomitantly diagnosed as CD. In group B, CD was diagnosed in 12 patients of NCPF (11) and EHPVO (1). Liver histology showed chronic hepatitis in two patients and was normal in three patients.

CONCLUSION: CD is common in PHT of different etiology, especially in cCLD, NCPH and autoimmune hepatitis; however, the etiological basis for this association is still to be defined. The likelihood of CD is higher in liver disease than the general population, and these patients should be screened for CD.

© 2019 Indian National Association for Study of the Liver. Published by Elsevier B.V. All rights reserved.

Keywords: AIH, autoimmune hepatitis; ANA, anti-nuclear antibody; ASMA, anti-smooth muscle antibody; Anti LKM, anti-liver kidney microsome antibody; BCS, Budd–Chiari syndrome; CD, celiac disease; CLD, chronic liver disease; EHPVO, extrahepatic portal vein obstruction; HBV, hepatitis B virus; HBs Ag, hepatitis B surface antigen; HLA, human leukocyte antigen; Ig G, immunoglobulin G; NCIPH, noncirrhotic idiopathic portal hypertension; NCPF, noncirrhotic portal fibrosis; NCPH, noncirrhotic portal hypertension; PHT, portal hypertension; c CLD, cryptogenic chronic liver disease; celiac disease; chronic liver disease; noncirrhotic portal hypertension; portal hypertension; tTG antibody, tissue transglutaminase antibody

Conflict of interest statement

The authors have none to declare.

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