{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T20:56:36Z","timestamp":1775854596024,"version":"3.50.1"},"reference-count":50,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2013,6,1]],"date-time":"2013-06-01T00:00:00Z","timestamp":1370044800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. pediatr. gastroenterol. nutr."],"published-print":{"date-parts":[[2013,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective:<\/jats:title><jats:p>The association between celiac disease (CD) and liver disease in pediatrics is widely recognized, but its prevalence is unknown. This study aims to conduct a systematic review and meta\u2010analysis to evaluate the prevalence of CD in children with cryptogenic persistent hypertransaminasemia (HTS) or autoimmune hepatitis (AIH), and vice versa.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods:<\/jats:title><jats:p>We searched MEDLINE\/PubMed, the Cochrane Library, Web of Science, and MD Consult from 1977 to May 2012 for studies reporting either CD and HTS or AIH. Pooled prevalences with 95% confidence intervals (CI) and relative risk (RR) were calculated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p>Nine studies (2046 patients) were identified. Pooled prevalences of CD in children with mild, nonspecific cryptogenic persistent HTS and vice versa were 12.0% (95% CI 4.17\u201329.96) and 36.0% (95% CI 32.15\u201340.11), respectively. A gluten\u2010free diet normalized transaminase levels in 77% to 100% of patients with CD within 4 to 8 months. Pooled prevalences of CD in children with AIH and vice versa were 6.3% (95% CI 3.87\u201311.73) and 1.4% (95% CI 0.84\u20132.15), respectively. The RR of HTS in children with CD versus the general population, and of CD in children with HTS was 6.55 (95% CI 5.65\u20137.60) and 11.59 (95% CI 3.80\u201335.33), respectively. The corresponding RR of AIH in children with CD was 188.54 (95% CI 92.23\u2013385.43). The RR of CD in children with AIH was 6.63 (95% CI 3.86\u201311.40).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions:<\/jats:title><jats:p>CD is associated with elevated transaminase levels in about one\u2010third of newly diagnosed children. Cryptogenic persistent HTS may signal gluten\u2010dependent nonspecific mild hepatitis (12.0% of cases) or more rarely (6.3%) severe CD\u2010related autoimmune hepatopathy. RRs confirm these trends in the considered associations.<\/jats:p><\/jats:sec>","DOI":"10.1097\/mpg.0b013e31828dc5c5","type":"journal-article","created":{"date-parts":[[2013,2,22]],"date-time":"2013-02-22T10:01:47Z","timestamp":1361527307000},"page":"663-670","source":"Crossref","is-referenced-by-count":57,"title":["Pediatric Celiac Disease, Cryptogenic Hypertransaminasemia, and Autoimmune Hepatitis"],"prefix":"10.1002","volume":"56","author":[{"given":"Pietro","family":"Vajro","sequence":"first","affiliation":[{"name":"School of Medicine at the University of Salerno Salerno and European Laboratory for the Investigation of Food\u2010Induced Diseases, ELFID Naples"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giulia","family":"Paolella","sequence":"additional","affiliation":[{"name":"School of Medicine at the University of Salerno Salerno and European Laboratory for the Investigation of Food\u2010Induced Diseases, ELFID Naples"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppe","family":"Maggiore","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University Hospital Santa Chiara Pisa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppe","family":"Giordano","sequence":"additional","affiliation":[{"name":"Department of Economics and Statistics University of Salerno Salerno Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,6]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2796.2011.02385.x"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2005.02.030"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2559.1977.tb01681.x"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(77)90954-0"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(78)91115-7"},{"key":"e_1_2_8_7_1","first-page":"959","article-title":"Hepatic damage in celiac disease in children","volume":"38","author":"Bonamico M","year":"1986","journal-title":"Minerva Pediatr"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.2165\/11593150-000000000-00000"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2011.04685.x"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00535-005-1635-7"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1442-200X.1998.tb01997.x"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2002.07127.x"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2009.04186.x"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.1840220322"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(05)83430-4"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(80)92309-0"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2010.02.006"},{"key":"e_1_2_8_18_1","first-page":"624","article-title":"Coeliac disease in children with autoimmune hepatitis","volume":"33","author":"Francavilla R","year":"2001","journal-title":"Dig Liver Dis"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.44.5.736"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2005.02328.x"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/j.1536-4801.2001.tb07466.x"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2004.01.012"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v11.i13.2039"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.1995.tb13738.x"},{"key":"e_1_2_8_25_1","doi-asserted-by":"crossref","unstructured":"SchwarzerG.Package \u2018meta\u2019. Meta\u2010analysis with R Version 2.1\u20104. 2012.","DOI":"10.7551\/mitpress\/9524.003.0005"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2009.02.048"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2003.029603"},{"key":"e_1_2_8_28_1","unstructured":"PouponR.Chronic autoimmune hepatitis.http:\/\/www.orpha.net. Updated March 2007. Accessed December 7 2012."},{"key":"e_1_2_8_29_1","first-page":"29","article-title":"Transition of adolescents with autoimmune hepatitis from pediatric to adult care","volume":"5","author":"Woynarowski M","year":"2009","journal-title":"Exp Clin Hep"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.2174\/1573396052953499"},{"key":"e_1_2_8_31_1","first-page":"424","article-title":"The prevalence of liver function abnormalities in pediatric celiac disease patients and its relation with intestinal biopsy findings","volume":"68","author":"Arslan N","year":"2005","journal-title":"Acta Gastroenterol Belg"},{"key":"e_1_2_8_32_1","unstructured":"RyanR HillS PrictorM et al. Cochrane Consumers and Communication Review Group.Study Quality Guide.2011.http:\/\/www.latrobe.edu.au\/chcp\/cochrane\/resources.html. Accessed December 7 2012."},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2007.12.002"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1053\/gast.1999.0029900297"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2008.04.008"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1093\/tropej\/fmq057"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2006.09.034"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1002\/j.1536-4801.1995.tb11969.x"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8278(97)80093-1"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-230X-12-92"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005176-198605000-00031"},{"key":"e_1_2_8_42_1","doi-asserted-by":"publisher","DOI":"10.1080\/00365520500235334"},{"key":"e_1_2_8_43_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02790391"},{"key":"e_1_2_8_44_1","doi-asserted-by":"publisher","DOI":"10.1002\/j.1536-4801.2003.tb08126.x"},{"key":"e_1_2_8_45_1","doi-asserted-by":"publisher","DOI":"10.1002\/j.1536-4801.1990.tb10134.x"},{"key":"e_1_2_8_46_1","doi-asserted-by":"publisher","DOI":"10.4049\/jimmunol.1101179"},{"key":"e_1_2_8_47_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2002.06031.x"},{"key":"e_1_2_8_48_1","doi-asserted-by":"publisher","DOI":"10.3109\/00365529008997589"},{"key":"e_1_2_8_49_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.42.1.120"},{"key":"e_1_2_8_50_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2005.02361.x"},{"key":"e_1_2_8_51_1","doi-asserted-by":"publisher","DOI":"10.1002\/j.1536-4801.2001.tb07547.x"}],"container-title":["Journal of Pediatric Gastroenterology and Nutrition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1097\/MPG.0b013e31828dc5c5","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,29]],"date-time":"2025-04-29T21:58:40Z","timestamp":1745963920000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1097\/MPG.0b013e31828dc5c5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,6]]},"references-count":50,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2013,6]]}},"alternative-id":["10.1097\/MPG.0b013e31828dc5c5"],"URL":"https:\/\/doi.org\/10.1097\/mpg.0b013e31828dc5c5","archive":["Portico"],"relation":{},"ISSN":["0277-2116","1536-4801"],"issn-type":[{"value":"0277-2116","type":"print"},{"value":"1536-4801","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,6]]}}}