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Essrani R, Berger A. Change in Patient MELD-Na and Albumin Level From the Time of Celiac Disease Diagnosis to Six Months Later After Gluten-Free Diet. Cureus. 2020;12(5):e8237doi: 10.7759/cureus.8237.
Essrani, R., & Berger, A. (2020). Change in Patient MELD-Na and Albumin Level From the Time of Celiac Disease Diagnosis to Six Months Later After Gluten-Free Diet. Cureus, 12(5), e8237. https://doi.org/10.7759/cureus.8237
Essrani, Rajesh, and Berger, Andrea. "Change in Patient MELD-Na and Albumin Level From the Time of Celiac Disease Diagnosis to Six Months Later After Gluten-Free Diet." Cureus vol. 12,5 (2020): e8237. doi: https://doi.org/10.7759/cureus.8237
Essrani R, Berger A. Change in Patient MELD-Na and Albumin Level From the Time of Celiac Disease Diagnosis to Six Months Later After Gluten-Free Diet. Cureus. 2020 May 22;12(5):e8237. doi: 10.7759/cureus.8237. PMID: 32582496; PMCID: PMC7306642.
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Cureus. 2020 May 22;12(5):e8237. doi: 10.7759/cureus.8237.

Change in Patient MELD-Na and Albumin Level From the Time of Celiac Disease Diagnosis to Six Months Later After Gluten-Free Diet.

Cureus

Rajesh Essrani, Andrea Berger

Affiliations

  1. Internal Medicine, Geisinger Medical Center, Danville, USA.
  2. Internal Medicine, Lehigh Valley Health Network, Allentown, USA.
  3. Biostatistics, Geisinger Medical Center, Danville, USA.

PMID: 32582496 PMCID: PMC7306642 DOI: 10.7759/cureus.8237

Abstract

Background & aims Celiac disease (CD) is a multisystem disorder triggered by dietary gluten in genetically predisposed individuals that may affect any organ system, including the liver. We evaluated a change in patient model for end-stage liver disease (MELD)-Na and albumin level from the time of celiac disease diagnosis to six months later, after implementing a gluten-free diet. Methods A retrospective study was conducted from January 1, 2006, to June 30, 2018. CD was diagnosed based on celiac antibodies and/or histopathological data. MELD-Na and albumin were calculated at the start of the gluten-free diet and six months later. Additional variables like gender, ethnicity, serum IgA level, serum IgG level, human leukocyte antigen (HLA) type, and markers of end-stage liver disease were collected. Descriptive statistics, including means, were reported with the standard deviation for the continuous variables along with frequencies and percentages for all categorical variables. Results A total of 18 patients (55.6% male) were identified as having both cirrhosis and CD. The mean age at the time of celiac diagnosis was 53.6, and 94.4% were Caucasian. CD was diagnosed using celiac antibodies (100%) and histopathological data (44.4%). Most common celiac antibodies include anti-tissue transglutaminase antibodies (77.8%). End-stage liver disease markers like abdominal ascites (55.6%), variceal bleed (50.0%), acute or chronic kidney injury (16.7%), hepatocellular carcinoma (HCC) (11.1%), hepatic encephalopathy (HE) (50.0%), spontaneous bacterial peritonitis (SBP) (5.6%), and liver transplant (0.0%) were seen. The mean baseline MELD-Na score was 11.8, and albumin was 3.5 at the time of celiac diagnosis and mean MELD-Na was 11.8, and albumin was 3.5 six months after a gluten-free diet. Conclusion It is difficult to conclude any exact relationship between change in MELD-Na score after gluten-free diet, but an improving trend is noted in patients with higher MELD-Na score such as 17 or higher. There is no change or worsening of MELD-Na score in patients with lower MELD-Na score. There was no change in mean MELD-Na and albumin level after gluten-free diet.

Copyright © 2020, Essrani et al.

Keywords: albumin; celiac disease; cirrhosis; meld-na

Conflict of interest statement

The authors have declared that no competing interests exist.

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