Çölyak hastalığının karaciğer tutulumları

Yıl 2017, Cilt: 80 Sayı: 3, 111 - 119, 01.09.2017

Tolga Düzenli Alpaslan Tanoğlu

https://doi.org/10.18017/iuitfd.363589

Öz

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. 

Anahtar Kelimeler

Çölyak hastalığı; Gluten; karaciğer

Liver manifestations of Celiac disease

Öz

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.

Anahtar Kelimeler

Celiac disease; Gluten; liver

Kaynakça

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