Çölyak hastalığının karaciğer tutulumları

Abstract

Çölyak hastalığı (ÇH) buğdaydaki glutene ve arpa, çavdar, yulaf gibi tahıllarda bulunan gluten benzeri diğer tahıl proteinlerine karşı kalıcı intoleransla karekterize, ağırlıklı olarak proksimal ince barsağı etkileyen bir hastalıktır. Bir enteropati olarak bilinmesine rağmen son yıllarda ortaya konulan ve belirginleşen gastrointestinal sistem dışı bulguları ile de kendini göstermektedir. ÇH, karaciğer enzim yüksekliklerinin %6-9’unu oluştururken, ÇH olanlarda ise karaciğer enzimlerindeki yükselme oranı %40’ lara varabilmektedir. ÇH’nda tek bulgu bazen karaciğer enzim yüksekliği olabildiği gibi; birçok karaciğer hastalığı ile ÇH birlikteliği de gösterilmiştir. Bu kapsamda ÇH tanısı konan hastalarda mutlaka karaciğer enzim taraması önerilmektedir. ÇH ilişkili karaciğer bozuklukları kriptojenik hipertransaminazemi ya da çölyak hepatiti ve otoimmün karaciğer hastalıkları olarak iki ana grupta değerlendirilebilir. Bunların yanında birçok karaciğer hastalığı ile de ÇH birlikteliği gösterilmiştir. Bu yazımızda ÇH ile karaciğer enzim yüksekliği ilişkisini inceleyerek, bu hastalıklara yaklaşımı özetlemeyi hedefledik. 

Keywords

• Çölyak hastalığı; Gluten; karaciğer

Liver manifestations of Celiac disease

Abstract

Celiac disease (CD) is characterized by persistent intolerance to wheat gluten and other gluten-like proteins found in cereals such as barley, rye, and oats. It predominantly affects the proximal small intestine. Although CD is known as an enteropathy, an increasing number of extraintestinal manifestations have appeared in recent years. Although CD accounts for 6%-9% of elevated hepatic enzymes, hypertransaminasemia can be seen in 40% of CD patients. Although the only finding could be hypertransaminasemia, many liver diseases and CD co-morbidities have also been demonstrated. In this regard, hepatic enzyme screening is recommended for patients diagnosed with CD. CD-related liver disorders may be categorized into two main groups: cryptogenic hypertransaminase/celiac hepatitis and autoimmune liver diseases. In addition, many liver diseases can be associated with CD. In this article, we aimed to summarize the relation between CD and liver enzyme elevation and the approach to treating hypertransaminasemia in CD patients.

Keywords

• Celiac disease; Gluten; liver

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