Case Report

Celiac Sprue Presenting as Advanced Liver Disease

Authors: Kiran Tiriveedhi, MD, Stephen P. Kelleher, MD

Abstract

This case report describes the complexity of diagnosing celiac sprue in a patient who presented with features predominantly resembling that of advanced liver disease in the absence of diarrhea.


Key Points


* Highly variable clinical presentations make the diagnosis of celiac sprue challenging.


* The association between celiac sprue and liver disease other than primary biliary cirrhosis, autoimmune hepatitis, or primary sclerosing cholangitis is not generally recognized.


* In a patient with celiac sprue, liver biopsy for abnormal liver tests is recommended only if there is no improvement with gluten-free diet.


* The differential diagnosis of unexplained advanced liver disease should include celiac sprue.

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