Celiac disease-associated autoimmune cholangitis

Robert E. Sedlack, Thomas C. Smyrk, Albert J. Czaja, Jayant A. Talwalkar

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31 Scopus citations


There is an association between celiac disease (CD) and primary biliary cirrhosis, but there is little information regarding the association between CD and autoimmune cholangitis (antimitochondrial antibody-negative primary biliary cirrhosis). We describe a case of a 60-yr-old woman with chronic serum liver biochemistry elevations, recent onset of pruritus, and unexplained iron deficiency anemia. Liver biopsy was suggestive of stage 1 primary biliary cirrhosis, but serum antimitochondrial antibody testing was negative. Subsequent evaluation revealed CD based on markedly elevated antiendomysial antibody titers and characteristic histological features on mucosal biopsies. Initiation of a gluten-free diet led to resolution of iron deficiency anemia, pruritus, and elevated serum liver biochemistries. This suggests that CD may play a direct role in the development of autoimmune cholangitis. Additionally, normalization of hepatic biochemistries may be achieved without the use of immunosuppressive agents in some patients. CD should be considered in all patients diagnosed with autoimmune cholangitis as a gluten-free diet may avoid the need for immunosuppressive therapy in affected patients.

Original languageEnglish (US)
Pages (from-to)3196-3198
Number of pages3
JournalAmerican Journal of Gastroenterology
Issue number12
StatePublished - Dec 1 2002

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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    Sedlack, R. E., Smyrk, T. C., Czaja, A. J., & Talwalkar, J. A. (2002). Celiac disease-associated autoimmune cholangitis. American Journal of Gastroenterology, 97(12), 3196-3198. https://doi.org/10.1016/S0002-9270(02)05548-X