Massive hepatic steatosis disclosing adult celiac disease. Study of a case and review of the literature

摘要: The authors report the case of a 32-year old woman admitted for hepatomegaly, weight loss, and moderate diarrhea. Liver function tests showed anicteric cholestasis with slight increase in serum level transaminases. biopsy demonstrated massive steatosis. Biological radiological investigations small intestine malabsorption pattern. Stool fat excretion was 54 g per day. Duodenal biopsies disclosed total villous atrophy. A ten-day treatment metronidazole (1,5 day), followed by gluten-free diet, resulted rapid improvement hepatic intestinal symptoms. This shows that: 1) adult celiac disease may be cause severe steatosis; 2) or without hepatomegaly during course secondary to steatosis, as well primary biliary cirrhosis malignant infiltration liver; 3) bacterial overgrowth should searched eventually treated fatty liver occurring disease.