Asymptomatic Elevated AST and ALT Levels in Celiac Disease

Elevations of serum aminotransferases (AST and ALT) can occur in asymptomatic patients with celiac disease. In this study from a university clinic in Italy, researchers searched for celiac disease in 168 mostly asymptomatic adults with persistent unexplained elevations of serum AST and ALT. In all patients, tests for viral hepatitis, autoimmune hepatitis, hemochromatosis, Wilson disease, and α₁-antitrypsin deficiency were negative. None of the patients abused alcohol or were taking hepatotoxic drugs.

Twenty patients were positive for IgA or IgG anti-tissue transglutaminase antibodies (anti-tTG), which are sensitive tests for celiac disease. Endoscopy and duodenal biopsy revealed evidence of celiac disease in 6 of the 20 patients. These 6 pat…