Liver involvement in pediatric celiac disease

Celiac disease （CD） is an intestinal inflammatory diseasethat manifests in genetically susceptible individualswhen exposed to dietary gluten. It is a common chronicdisorder, with a prevalence of 1% in Europe and NorthAmerica. Although the disease primarily affects the gut,the clinical spectrum of CD is remarkably varied, andthe disease can affect many extraintestinal organs andsystems, including the liver. The hepatic dysfunctionpresenting in CD ranges from asymptomatic liverenzyme elevations or nonspecific reactive hepatitis（cryptogenic liver disorders）, to chronic liver disease.In this article, we review the clinical presentationsand possible mechanisms of CD-related liver injury toidentify strategies for the diagnosis and treatment ofthese disorders in childhood.