An autoimmune disease refractory to immunosuppressive regimens: Celiac disease diagnosed long after liver transplantation
Makaleler > Tam Makale · 2013
Yazarlar: Cigdem ECEVIT, Miray KARAKOYUN, Fatih UNAL, Hasan A. YUKSEKKAYA, Başak DOĞANAVŞARGİL YAKUT, Rasit V. YAGCI, Sema AYDOĞDU
Pediatric Transplantation, SCI Expanded İndekslerine Giren Dergi, Uluslararası, Wos, 2013, cilt 17, ss E156-60
DOI: 10.1111/petr.12136
Özet
CD is defined as T-lymphocyte-mediated gluten sensitivity. Although CD is known to affect the small intestine, it is nonetheless a multisystem disorder. Liver involvement in CD may vary from isolated hypertransaminasemia to cirrhosis. Because CD is an inappropriate immune response to gluten proteins, strict gluten-free diet is the principal therapy, along with management of liver dysfunction. In patients who fail to respond to a gluten-free diet, immunosuppressive drugs may improve intestinal inflammatory activity in untreated CD. The present case report is of a 25-yr-old woman with diarrhea lasting several weeks. The patient had received a liver transplant 13 yr earlier, and presented with cryptogenic cirrhosis diagnosed as CD. This appears to be the first case of its kind in which a pediatric long-term liver transplant patient presents with diarrhea eventually diagnosed as CD whose diet included gluten, and who was treated by an immunosuppressive drug regimen. Because of the normalization of CD-related antibodies in the post-transplantation period without gluten restriction, CD should be part of a list of diagnostic possibilities in liver transplant patients presenting with diarrhea of unknown etiology.