Background: Celiac disease is (CD) a genetically determined chronic inflammatory
disease induced by an environmental precipitant. It is a multisystem disease and can
develop at any point of time during life in genetically susceptible individuals upon
ingestion of wheat gluten and related cereal proteins. The onset of symptoms in the
atypical form generally occurs between 4-15 years of age. Diagnosis of CD with extraintestinal
manifestations is frequently missed as it presents without diarrhoea.
Objective: To observe the frequency of celiac disease in children with liver disease.
Methods: This cross sectional study was conducted at BSMMU from January 2014
to June 2015. A total of 59 children (age 18 months to16 years) with clinical and
biochemical features of liver disease were initially enrolled for the study. Their clinical
history, examination findings and investigation reports were recorded in a data collection
sheet and informed consent was obtained from parents. Routine investigations, liver
function tests, tissue transglutaminase tTG (IgA), total IgA. were done. After exclusion
of other causes of liver disease endoscopy of upper gastrointestinal tract (GIT) was
done on patients who were tTG (titer of >50 iu/mL) positive. Patients who were tTG
negative but found IgA deficient (1 patient) was also selected for upper GI endoscopy
and biopsy fragments were taken from second part of duodenum (D2) sent for
histopathology.