Gluten-Free hepatomiracle in “celiac hepatitis”: A case highlighting the rare occurrence of nutrition-induced near total reversal of advanced steatohepatitis and cirrhosis

• Main Authors: Kavita Gaur, Puja Sakhuja, Amarender S Puri, Kaushik Majumdar
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2016-01-01
• Series: The Saudi Journal of Gastroenterology
• Subjects: Celiac disease; fibrosis; gluten free diet; liver
• Online Access: http://www.saudijgastro.com/article.asp?issn=1319-3767;year=2016;volume=22;issue=6;spage=461;epage=464;aulast=Gaur

Regression of hepatic fibrosis is increasingly becoming a reality, both in clinical as well as experimental models. Reversal or near-total regression of marked liver steatohepatitis and fibrosis, however, remains a rare event. We report the case of a 20-year-old female presenting with diarrhea due to celiac disease and biopsy proven cirrhosis with portal hypertension who had a remarkable clinical improvement in response to a gluten free diet (GFD). A follow-up liver biopsy 9 months after the initiation of GFD revealed a remarkable regression of both fibrosis as well as steatosis. Villous atrophy, as seen in patients with celiac disease, could lead to a deprivation of trophic factors leading to liver injury and subsequent cirrhosis. A gluten-free dietary regimen can produce a reversal of fibrosis leading to the amelioration of symptoms associated even with advanced liver disease.