<<Disclaimer: Verify this information before applying it to your situation.>> Dear Listmates: I found this very interesting professional article in Medscape. Registration is free. Just click on http://www.medscape.com/ to view the site and register so you can search for different subjects of interest. The following is an article about screening for celiac disease in patients with chronic unexplained hypertransaminasemia: --- According to a report in the March 1999 issue of Hepatology, screening for celiac disease (CD) appears to be an important tool in the initial assessment of patients with chronic unexplained hypertransaminasemia. Elevations in serum transaminase level are often associated with chronic liver disease, including viral infections, cirrhosis, and genetic/acquired metabolic disorders. However, chronic elevations of serum transaminases often occur in the absence of comorbid liver disease as well, as have been reported in patients with CD. Because of the relatively high incidence of CD and the frequency of subclinical presentation, it has been suggested that undiagnosed cases of CD may be identified among patients with chronically elevated serum transaminases. Bardella and coworkers tested 140 consecutive patients with chronic unexplained hypertransaminasemia for antigliadin (AGA) and antiendomysium (EmA) IgA antibodies by indirect immunofluorescence. Results found that 13 of these subjects were positive for AGA and EmA IgA; the 12/13 who subsequently consented to and underwent endoscopy and distal duodenal biopsy showed histology consistent with CD. The prevalence of celiac disease in this patient group was significantly greater than that in the general population. These findings suggest that chronic hypertransaminasemia may be a marker of silent CD; screening for CD in patients with chronic elevations in serum transaminases before investigations for rarer disease entities are undertaken is therefore warranted. Source: Bardella MT, Vecchi M, Conte D, et al: Chronic Unexplained Hypertransaminasemia May Be Caused by Occult Celiac Disease. Hepatology 29:654-657, 1999.