Patients with primary sclerosing cholangitis, primary biliary cholangitis (PBC), autoimmune hepatitis, aminotransferase elevations, nonalcoholic fatty liver disease, hepatitis B, hepatitis C, portal hypertension, and liver cirrhosis should be evaluated for celiac disease, suggests a recent report. Such screening is especially important in patients with autoimmune disorders, which includes PBC, steatosis that is not accompanied by metabolic syndrome, noncirrhotic intrahepatic portal hypertension, cryptogenic cirrhosis, and in patients with liver transplants.

Arriving at a diagnosis of celiac disease is also important in patients with hepatitis C because it may justify withholding interferon therapy. (The gluten intolerance disease is a relative contraindication for interferon.) The authors point out, however, that although a gluten-free regimen usually relieves the symptoms of celiac disease, it may or may not have any effects on any underlying liver disease.