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Investigation into celiac disease in Indian patients with portal hypertension

  • Original Article
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Indian Journal of Gastroenterology Aims and scope Submit manuscript

Abstract

Background

There is limited data on celiac disease in patients with cryptogenic cirrhosis or idiopathic noncirrhotic intrahepatic portal hypertension (NCIPH). Our objective was to evaluate for celiac disease in patients with portal hypertension in India.

Methods

Consecutive patients with portal hypertension having cryptogenic chronic liver disease (cases) and hepatitis B- or C-related cirrhosis (controls) were prospectively enrolled. We studied tissue transglutaminase (tTG) antibody and duodenal histology in study patients.

Result

Sixty-one cases (including 14 NCIPH patients) and 59 controls were enrolled. Celiac disease was noted in six cases (including two NCIPH patients) as compared to none in controls. In a significant proportion of the remaining study subjects, duodenal biopsy showed villous atrophy, crypt hyperplasia, and lamina propria inflammation, not accompanied by raised intraepithelial lymphocytes (IELs); this was seen more commonly in cases as compared to controls. An unexpectedly high rate of tTG antibody positivity was seen in study subjects (66 %) of cases as compared to 29 % in controls (p-value < 0.001), which could indicate false-positive test result.

Conclusion

In this study, 10 % of patients with unexplained portal hypertension (cryptogenic chronic liver disease) had associated celiac disease. In addition, an unexplained enteropathy was seen in a significant proportion of study patients, more so in patients with cryptogenic chronic liver disease. This finding warrants further investigation.

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Acknowledgments

This study was funded by Fluid Research at Christian Medical College, Vellore, India.

Conflict of interest

RM, AG, ABP, SB, JS, CP, KAB, BR, SK, GJF, PA, GK, BSR, EE, and CEE all confirm that they have no conflict of interest to declare.

Ethics statement

The study was performed in a manner to conform with the Helsinki Declaration of 1975, as revised in 2000 and 2008 concerning Human and Animal Rights, and the authors followed the policy concerning informed consent as shown on Springer.com.

Author information

Authors and Affiliations

  1. Department of Gastrointestinal Sciences, Christian Medical College, Vellore, 632 004, India

    Rakhi Maiwall, Ashish Goel, Anna B. Pulimood, Sudhir Babji, J. Sophia, K. A. Balasubramanian, Gagandeep Kang, B. S. Ramakrishna, Elwyn Elias & C. E. Eapen

  2. Department of Pathology, Christian Medical College, Vellore, 632 004, India

    Chaya Prasad, Banumathi Ramakrishna & Susy Kurian

  3. Department of Virology, Christian Medical College, Vellore, 632 004, India

    G. John Fletcher & Priya Abraham

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  1. Rakhi Maiwall
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  15. C. E. Eapen
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Corresponding author

Correspondence to C. E. Eapen.

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Maiwall, R., Goel, A., Pulimood, A.B. et al. Investigation into celiac disease in Indian patients with portal hypertension. Indian J Gastroenterol 33, 517–523 (2014). https://doi.org/10.1007/s12664-014-0501-z

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  • DOI: https://doi.org/10.1007/s12664-014-0501-z

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