Gluten-free diet improves celiac disease associated with cryptogenic cirrhosis, suggests study

Key Findings

Prevalence of CeD in Cryptogenic Cirrhosis :

• Among 232 patients, 14 had elevated anti-tTG antibody levels (16.9±10.5-fold rise), 9 were AEA positive, and 11 (4.7%) were biopsy-proven for CeD.

Baseline Characteristics:

Patients with CeD (n=11) and matched controls (n=44) showed similar baseline demographics and liver disease severity:

• Age: 31.3±7.7 (CeD) vs. 31.8±9.3 years (non-CeD).

• Females: 45.5% (CeD) vs. 34.1% (non-CeD).

• MELD score: Median 9 (IQR: 8–15.5) vs. 12 (9–15).

• CTP score: Median 7 (IQR: 6–7.5) vs. 6 (5.75–7).

Liver Outcomes with GFD:

• Patients with CeD on GFD showed significant improvements in liver scores compared with patients without CeD.

• Follow-up MELD score: Median 9 (IQR: 7.5–10.5) vs. 18.5 (12–20) (p=0.001).

• Follow-up CTP score: Median 5 (IQR: 5–5) vs. 8 (7–9) (p<0.001).

• The number of decompensation events was smaller, and the mortality was not significantly different between CeD patients and non-CeD controls.

• Decompensations: Less frequent in CeD group; no numbers were reported.

• Mortality: 9.1% (CeD) vs. 18.2% (non-CeD) (p=0.67).

Liver-related outcomes improved significantly with GFD among these patients, which signifies the importance of early diagnosis and dietary intervention in this population.

Reference:

Pachisia, A. V., Agarwal, A., Mehta, S., Kumari, A., Dwarakanathan, V., Sharma, S., Kumar, S., Mehra, L., Dutta, R., Das, P., Agrawal, S., Shalimar, Ahuja, V., & Makharia, G. K. (2024). Celiac disease is common in adults with cryptogenic cirrhosis and responds favourably to gluten-free diet. The American Journal of Gastroenterology, 10.14309/ajg.0000000000003244.https://doi.org/10.14309/ajg.0000000000003244