Coeliac disease prevalent in patients with liver disorder

Coeliac disease (CeD) appears to be common in patients with cryptogenic cirrhosis or cryptogenic hypertransaminasaemia, suggests a study, noting that these individuals must be considered high-risk groups for CeD.

In this systematic review and meta-analysis, a team of investigators searched the databases of PubMed and Embase up to January 2022. They identified cross-sectional, case-control, and prospective cohort studies that performed serological tests or intestinal biopsy for CeD on patients with cryptogenic cirrhosis, all-cause cirrhosis, cryptogenic hypertransaminasaemia, and all-cause hypertransaminasaemia.

Pooled estimates of seroprevalence as well as the prevalence of biopsy-confirmed CeD in the four groups were then calculated.

A total of 6,871 articles were evaluated, but only 20 met the inclusion criteria and were included in three meta-analyses for cryptogenic cirrhosis, all-cause cirrhosis, and cryptogenic hypertransaminasaemia. The investigators conducted a qualitative review of four studies for the all-cause hypertransaminasaemia group instead of a meta-analysis due to significant differences in the studies.

The pooled prevalence of biopsy-confirmed CeD in cryptogenic cirrhosis was 4.6 percent (95 percent confidence interval [CI], 2.2‒7.5), while that in all-cause cirrhosis was only 0.8 percent (95 percent CI, 0‒3.4). Finally, the pooled prevalence of biopsy-confirmed CeD in cryptogenic hypertransaminasaemia was 5.7 percent (95 percent CI, 3.2‒8.8).

“While the prevalence of CeD in those with all-cause cirrhosis is similar to that in general population, it may be worth screening them for CeD because liver pathology has the potential for reversal in them,” the investigators said.