Prevalence of coeliac disease in autoimmune liver disease and primary biliary cholangitis
Background: Coeliac disease (CD) is a small bowel disease, which occurs upon exposure to dietary gluten. CD is often associated with dermatitis herpetiformis, autoimmune thyroid disease, type 1 diabetes mellitus and autoimmune liver diseases. Autoimmune hepatitis (AIH) and primary biliary cholangitis (PBC) are the most common autoimmune liver diseases. In this study, we investigated the prevalence of CD in patients with PBC, AIH and overlapping PBC + AIH in our Hospital.
Methods: Ninety-nine patients with PBC, AIH and overlapping AIH + PBC were included in this study. Specific serum antibodies and specific duodenal biopsy results are used for diagnosis of CD.
Results: Ninety-nine patients with PBC (n = 47; F: 95.7%; age: 53 ± 10 years), AIH (n = 23; F: 100%; age: 48 ± 12 years) and overlapping AIH + PBC (n = 29;F : 96.6%; age: 51 ± 10.9 years) were included in this study.Three patients (6.4%) in the PBC group, one patient (3%) in the PBC + AIH group and two patients (8.7%) in the AIH group were serologically and histologically diagnosed with CD.
Conclusion: Anti-gliadine antibody (AGA) positivity or anti-endomysium antibody (EMA) positivity alone was not sufficient for CD diagnosis. We suggest using both tests for CD screening to achieve more accurate results. In cases of positive CD-specific antibody results, we advise confirming the diagnosis by histopathological examination of duodenal biopsies.