Aralik 2019
Yeni tani almis çölyak hastalarinda tani aninda karaciger fonksiyon testlerinin analizi
Analysis of liver function tests in patients newly diagnosed with celiac disease
- Ana Sayfa
- Sayılar
- Aralik 2019
- Yeni tani almis çölyak hastalarinda tani aninda karaciger fonksiyon testlerinin analizi...
Özet
Giris ve Amaç: Tedavi almayan çölyak hastaliginda karaciger anormallikleri siktir. Çölyak hastaligi direkt karaciger hasari yapabilecegi gibi di- ger karaciger hastaliklariyla da birliktelik gösterebilir. Çölyak hastaligina sahip yetiskinlerin %24-40’inda tani aninda izole hipertransaminazemi rapor edilmistir. Ortalama bir yil uygulanan glütenden fakir diyet hem karaciger enzimlerini hem de karacigerdeki histolojik degisiklikleri geri döndürebilmektedir. Çalismamizda çölyak hastaliginda tani aninda karaciger fonksiyon testlerinin degerlendirilmesi ve transaminaz yüksekliginin olasi nedenlerinin arastirilmasi amaçlandi. Gereç ve Yöntem: 2012-2017 yillari arasinda çölyak hastaligi tanisi alan 100 hastanin klinik bulgulari, laboratuvar degerleri, duodenal ve karaciger biyopsileri retrospektif olarak analiz edildi. Çölyak transaminitisi tanisi alan hastalarda 1 yillik glütensiz diyet sonrasi transaminaz degerleri de incelenmistir. Bulgular: Çölyak hastaligi tanisi sirasinda 36 hastada es zamanli olarak transaminaz yüksekligi tespit edilmis olup klinik ve varsa histopatolojik verileri degerlendirildiginde bunlarin 2 tanesinde kronik viral hepatit B, 34 tanesinde ise çölyak transaminitisi tespit edilmistir. Ortalama aspartat aminotransferaz düzeyi 45.2±50.0 IU/L ve ortalama alanin aminotransferaz düzeyi 44.6±43.6 IU/L idi. Transaminaz yüksekligi ile demografik veriler arasinda bir korelasyon saptanmamistir (p: 0.53). Çölyak transaminitisi tanisi alan 34 hastanin 31 tanesinde 1 yilllik glütenden fakir diyet sonrasi transaminaz degerlerinin normale döndügü izlenmistir. Sonuç: Yeni tani almis çölyak hastalarinda karaciger fonksiyon testleri yüksekligi; diger spesifik karaciger hastaliklari disinda çölyak hastaligina bagli olabilir ve %34 gibi sik oranda görülür. Genellikle de hastalar glü- tenden fakir diyet tedavisine yanit verirler
Abstract
ackground and Aims: Liver anomalies frequently occur in untreated celiac disease. Notably, celiac disease not only causes direct liver injury but also other liver diseases. Isolated hypertransaminasemia was reported in 24%–40% of adults diagnosed with celiac disease. Nevertheless, liver enzyme level and histological changes in the liver can be reversed by adhering to a gluten-free diet for 1 year on average. In this study, we aimed to evaluate liver function tests during celiac disease diagnosis and investigate the probable causes of hypertransaminasemia. Materials and Methods: The clinical signs, laboratory values, and duodenal and liver biopsies were retrospectively analyzed in 100 patients who were diagnosed with celiac disease between 2012 and 2017. Transaminase values after 1year of gluten-free diet were examined in patients with celiac transaminitis. Results: Overall, 36 patients were noted to have high levels of transaminase at the time of their celiac disease diagnosis. Upon clinical and histopathological evaluation, two patients had chronic viral hepatitis and 34 had celiac transaminitis. Average aspartate aminotransferase and alanine transaminase levels were 45.2±50.0 IU/L and 44.6±43.6 IU/L, respectively. A correlation was observed between high levels of transaminase and demographic data (p = 0.53). Transaminase levels of the 34 patients with celiac disease were observed to normalize after 1 year of gluten-free diet. Conclusions: In patients newly diagnosed with celiac disease, high levels of transaminase may be due to celiac disease besides other specific liver diseases, with an incidence rate of 34%. Patients usually respond to a gluten-free diet.
