Severe Liver Damage in an Obese Patient: Onset of Celiac Disease or Overlap Syndrome?

• Published in: Diagnostics (Basel) Vol. 14; no. 16; p. 1832
• Main Authors: Ghiga, Gabriela, Boca, Laura Otilia, Cojocaru, Elena, Stârcea, Iuliana Magdalena, Țarcă, Elena, Scurtu, Ana Maria, Mocanu, Maria Adriana, Ioniuc, Ileana, Tîrnovanu, Mihaela Camelia, Trandafir, Laura Mihaela
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 01-08-2024; MDPI
• Subjects: Abdomen; Antibodies; Autoantibodies; autoimmune hepatitis; Autoimmunity; Case Report; Causes of; Celiac disease; Development and progression; Diagnosis; Diseases; Gastrointestinal system; Gluten; gluten-free diet; Hepatitis; Liver cirrhosis; liver disease; Liver diseases; Medical research; Medicine, Experimental; Metabolism; Obesity; Romania; Small intestine; Ultrasonic imaging; Romania; celiac disease; autoimmune hepatitis; gluten-free diet; liver disease; hepatitis
• ISSN: 2075-4418; 2075-4418
• DOI: 10.3390/diagnostics14161832

Celiac disease (CeD) is an enteropathy caused by the complex interaction between genetic, environmental, and individual immunological factors. Besides the hallmark of intestinal mucosal damage, CeD is a systemic disorder extending beyond the gastrointestinal tract and impacting various other organs, causing extraintestinal and atypical symptoms. The association between CeD and liver damage has been classified into three main categories: mild and asymptomatic liver injury, autoimmune liver injury, and liver failure. We present a case of severe liver damage with cirrhotic evolution in an obese 12-year-old boy who had been admitted due to generalized jaundice and localized abdominal pain in the right hypochondrium. In the course of investigating the etiology of severe liver disease, toxic, infectious, metabolic, obstructive, and genetic causes were excluded. Despite the patient's obesity, a diagnosis of CeD was established, and in accordance with autoimmune hepatitis (AIH) criteria, the patient was diagnosed with autoantibody-negative AIH associated to CeD.