PMID- 32582496
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200928
IS  - 2168-8184 (Print)
IS  - 2168-8184 (Electronic)
IS  - 2168-8184 (Linking)
VI  - 12
IP  - 5
DP  - 2020 May 22
TI  - Change in Patient MELD-Na and Albumin Level From the Time of Celiac Disease 
      Diagnosis to Six Months Later After Gluten-Free Diet.
PG  - e8237
LID - 10.7759/cureus.8237 [doi]
LID - e8237
AB  - Background & aims Celiac disease (CD) is a multisystem disorder triggered by 
      dietary gluten in genetically predisposed individuals that may affect any organ 
      system, including the liver. We evaluated a change in patient model for end-stage 
      liver disease (MELD)-Na and albumin level from the time of celiac disease 
      diagnosis to six months later, after implementing a gluten-free diet. Methods A 
      retrospective study was conducted from January 1, 2006, to June 30, 2018. CD was 
      diagnosed based on celiac antibodies and/or histopathological data. MELD-Na and 
      albumin were calculated at the start of the gluten-free diet and six months 
      later. Additional variables like gender, ethnicity, serum IgA level, serum IgG 
      level, human leukocyte antigen (HLA) type, and markers of end-stage liver disease 
      were collected. Descriptive statistics, including means, were reported with the 
      standard deviation for the continuous variables along with frequencies and 
      percentages for all categorical variables. Results A total of 18 patients (55.6% 
      male) were identified as having both cirrhosis and CD. The mean age at the time 
      of celiac diagnosis was 53.6, and 94.4% were Caucasian. CD was diagnosed using 
      celiac antibodies (100%) and histopathological data (44.4%). Most common celiac 
      antibodies include anti-tissue transglutaminase antibodies (77.8%). End-stage 
      liver disease markers like abdominal ascites (55.6%), variceal bleed (50.0%), 
      acute or chronic kidney injury (16.7%), hepatocellular carcinoma (HCC) (11.1%), 
      hepatic encephalopathy (HE) (50.0%), spontaneous bacterial peritonitis (SBP) 
      (5.6%), and liver transplant (0.0%) were seen. The mean baseline MELD-Na score 
      was 11.8, and albumin was 3.5 at the time of celiac diagnosis and mean MELD-Na 
      was 11.8, and albumin was 3.5 six months after a gluten-free diet. Conclusion It 
      is difficult to conclude any exact relationship between change in MELD-Na score 
      after gluten-free diet, but an improving trend is noted in patients with higher 
      MELD-Na score such as 17 or higher. There is no change or worsening of MELD-Na 
      score in patients with lower MELD-Na score. There was no change in mean MELD-Na 
      and albumin level after gluten-free diet.
CI  - Copyright (c) 2020, Essrani et al.
FAU - Essrani, Rajesh
AU  - Essrani R
AD  - Internal Medicine, Geisinger Medical Center, Danville, USA.
AD  - Internal Medicine, Lehigh Valley Health Network, Allentown, USA.
FAU - Berger, Andrea
AU  - Berger A
AD  - Biostatistics, Geisinger Medical Center, Danville, USA.
LA  - eng
PT  - Journal Article
DEP - 20200522
PL  - United States
TA  - Cureus
JT  - Cureus
JID - 101596737
PMC - PMC7306642
OTO - NOTNLM
OT  - albumin
OT  - celiac disease
OT  - cirrhosis
OT  - meld-na
COIS- The authors have declared that no competing interests exist.
EDAT- 2020/06/26 06:00
MHDA- 2020/06/26 06:01
PMCR- 2020/05/22
CRDT- 2020/06/26 06:00
PHST- 2020/06/26 06:00 [entrez]
PHST- 2020/06/26 06:00 [pubmed]
PHST- 2020/06/26 06:01 [medline]
PHST- 2020/05/22 00:00 [pmc-release]
AID - 10.7759/cureus.8237 [doi]
PST - epublish
SO  - Cureus. 2020 May 22;12(5):e8237. doi: 10.7759/cureus.8237.