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• W4255516614 abstract "Carroccio et al.1Carroccio A. Soresi M. Di Prima L. Montalto G. Screening for celiac disease in patients with chronic liver disease.Gastroenterology. 2003; 125: 1289Abstract Full Text Full Text PDF PubMed Scopus (4) Google Scholar obtained in their series a lower frequency of celiac disease than we found in patients suffering from a severe liver disease.2Kaukinen K. Halme L. Collin P. Färkkilä M. Mäki M. Vehmanen P. Partanen J. Höckerstedt K. Celiac disease in patients with severe liver diseases gluten-free diet may reverse hepatic failure.Gastroenterology. 2002; 122: 881-888Abstract Full Text Full Text PDF PubMed Scopus (255) Google Scholar Their frequency of celiac disease, approximately 1%, reflects the prevalence of the disease in the general population. In other studies where screening has been employed in patients with elevated liver enzymes, 9%3Bardella M.T. Vecchi M. Conte D. Del Ninno E. Fraquelli M. Pacchetti S. Minola E. Landoni M. Cesana B.M. De Franchis R. Chronic unexplained hypertransaminasemia may be caused by occult celiac disease.Hepatology. 1999; 29: 654-657Crossref PubMed Scopus (173) Google Scholar, 4Volta U. De Franceschi L. Lari F. Molinaro N. Zoli M. Bianchi F.B. Coeliac disease hidden by cryptogenic hypertransaminasemia.Lancet. 1998; 352: 26-29Abstract Full Text Full Text PDF PubMed Scopus (208) Google Scholar have suffered from celiac disease. As the authors pointed out, the high number of chronic viral hepatitis, which is relatively uncommon in Finland, might explain their lower celiac frequency. In screening studies where autoimmune hepatitis is prevailing, the percentage of HLA DQ2 and DQ8, and consequently of celiac disease, is expected to be higher. Interestingly, an increased frequency of celiac disease in end-stage autoimmune liver diseases has recently been reported also in the United States.5Abdulkarim A.S. Wiesner R.H. Murray J.A. Krause P.K. Rochester M.N. Tissue transglutaminase antibodies are frequent in severe chronic liver disease with celiac disease associated HLA type.Gastroenterology. 2002; 122: A179-A180Google Scholar We agree with Carroccio et al.1Carroccio A. Soresi M. Di Prima L. Montalto G. Screening for celiac disease in patients with chronic liver disease.Gastroenterology. 2003; 125: 1289Abstract Full Text Full Text PDF PubMed Scopus (4) Google Scholar that anti-tissue transglutaminase antibody test based on human recombinant technique is today the method of choice in celiac screening. Their diagnostic algorithm is appropriate. However, 2%–5% of celiac patients remain negative for both HLA DQ2 and DQ8, but they usually carry one part of the DQ2 heterodimer, i.e., DQA1∗05 or DQB1∗02 allele alone.6Karell K. Louka A. Moodie S.J. Ascher H. Clot F. Greco L. Ciclitira P. Sollid L.M. Partanen J. HLA types in celiac disease patients not carrying the DQA1∗05–DQB1∗02 (DQ2) heterodimer Results from the European Genetics Cluster on Celiac Disease.Hum Immunol. 2003; 64 (in press)Crossref Scopus (491) Google Scholar Some of these patients might be negative for anti-endomysial antibodies, which are closely associated with HLA DQ2 and DQ8.7Mäki M. Holm K. Lipsanen V. Hällström O. Viander M. Collin P. Savilahti E. Koskimies S. Serological markers and HLA genes among healthy first-degree relatives of patients with coeliac disease.Lancet. 1991; 338: 1350-1353Abstract PubMed Scopus (185) Google Scholar Therefore, when the clinical suspicion of celiac disease is high, small intestinal biopsy should be considered despite of non-celiac HLA-type." @default.
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• W4255516614 doi "https://doi.org/10.1016/j.gastro.2003.08.019" @default.
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