Document Type : Meta-analysis
Authors
1 Faculty of Medicine and Health Sciences, Catholic University of Valencia, 46001 Valencia, Spain.
2 Faculty of Medicine, University of Zaragoza, IIS Aragón (CIBERehd), Spain.
Abstract
Background: Recent studies investigating the prevalence of celiac disease (CD) in patients with autoimmune hepatitis (AIH) have revealed highly variable findings. We therefore aimed to evaluate the prevalence of CD in cases with AIH.
Methods: Two independent professional librarians searched Scopus, EBSCO, Google Scholar, PubMed, EMBASE, Cochrane and Web of Science Core Collection from inception to November 2021. The terms used in our systematic search included ‘celiac disease’, ‘celiac’, ‘transglutaminases’, ‘gluten’, ‘gliadin’, ‘EMA’, ‘TTG’ and ‘villous’ in combination with ‘autoimmune’, ‘hepatitis’, ‘ANA’, ‘SMA’ and ‘LKM’. This investigation yielded 645 unique published papers. A systematic review based on the PRISMA guidelines resulted in 56 papers eligible for full text evaluation. Fifteen papers were deemed eligible, with 8 being included in our main pooled analysis.
Results: Our main analysis included 567 cases with AIH from eight papers, where biopsy-verified CD (equivalent to Marsh III) was reported in 23 subjects (4.1%). The pooled prevalence of CD in AIH was 4.5% (95% CI = 3%-6.8%) (heterogeneity: P = 0.52; I2 = 0), which is considerably higher than the 1% CD reported in most general populations. When also including papers where CD had been diagnosed through positive serology without biopsy (15 studies: n = 1817 cases with AIH), the pooled prevalence of CD was 5.4% (95% CI = 3%-9.5%) (heterogeneity: P < 0.01; I2 = 84.49%).
Conclusion: Our findings showed a higher prevalence of CD in cases with AIH compared to the healthy subjects. CD screening should be carried out in cases with AIH.
Keywords
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