Assessment of hypertransaminasaemia in children with newly diagnosed coeliac disease

Introduction
Coeliac disease (CD) is a chronic systemic disorder triggered by ingestion of gluten in generally susceptible individuals and characterised by small intestinal enteropathy. Hypertransaminasaemia is one of the extra-intestinal symptoms of CD, well-defined in adults, but with a limited number of studies from the paediatric population.

Aim of the study
The aim of our study was to assess the prevalence of abnormal liver enzyme values in newly diagnosed children with CD.

Material and methods
We retrospectively analysed 168 children with newly diagnosed CD. The diagnosis of CD was detected by serologic testing of coeliac-specific antibodies (anti-transglutaminase antibodies and/or endomysial antibodies) and confirmed by duodenal mucosal biopsies. The blood parameters of alanine aminotransferase (ALT) were collected when available at the time of diagnosis from 137 (81.6%) children who we included in the study. This group was composed of 73 girls and 64 boys, 11-202 months old.

Results
Prevalence of elevated ALT, defined as > 30 U/l, was 30.7%. We found no significant associations between increased transaminase levels and age, gender, or clinical presentation of CD. When we consider a value of > 40 U/l as a definition of elevated ALT, we found a prevalence 10.9%. Children with hypertransaminasaemia were younger (p = 0.01) and more commonly presented gastrointestinal symptoms (p = 0.03).

Conclusions
Elevated ALT is a common finding in children with CD – more often among younger groups.