Background: Celiac Disease (CD) is known as a gluten enteropathy, it is a disease that affects many organs, and findings outside the gastrointestinal tract are common. CD-associated liver disease is probably developed by variable factors, comprising intestinal bacterial overgrowth, chronic infection and inflammation, gut permeability, genetic, molecular mimicry, and predisposition of genes.

Objectives: Assessment of liver function in patients with celiac Disease.

Patients and Methods: A cross-sectional study was conducted, included 62 newly diagnosed children with celiac disease, at Pediatrics Hepatology Department - Children Welfare Teaching Hospital during period from 1st February 2023 till 1st November 2023. Data was collected using a questionnaire paper including personal and clinical examination with baseline requested lab investigations. Data including 62 child with newly diagnose celiac disease approved by positive serology and endoscopic findings. The questionnaire includes demographic and anthropometric measurements, initial presentation and laboratory investigations (complete blood count, blood film, liver function tests) Data frequencies and percentages were represented by tables and figures. P value < 0.05 was considered as statistically significant.

Results: Mean age of participants was 7.7±1.9 years, and mean BMI of 15.24±2.19 kg/m2. Males were 28 (45.2%) while females were 34 (54.8%). A significant higher Body mass index of females in comparison to males was found (P<0.001). According to the first presentation, there were 19 (30.60%) participants presented to screen for celiac disease because of short stature, 17 (27.40%) with diarrhea, 6 (9.70%) with anemia, 4 (6.50%) with abdominal pain. Marsh score was 1 among 18 (29.0%) participants, score 2 among 15 (24.2%), and score 3 among 29 (46.8%). Mean level of ALT was 49.06±26.77 (IU/l), mean of AST was 41.79±32.22 (IU/l), and mean of TSB was 0.59±0.27 μmol/l.      

MARSH score 3 was associated significantly with weight and height at ≤5th percentile, underweight, short stature, with lower BMI mean, and with higher levels of anti-tissue IgA, anti-tissue IgG, ALT, and AST; (P<0.05). Higher ALT and AST levels were associated significantly with short stature (P=0.001). There was a significant decrease in the mean level of both ALT and AST after 3-6 months gluten-free diet (GFD) introduction in comparison to those before GFD; P<0.001.

Conclusions: Nearly half (46.8%) of participants presented as Marsh score 3. MARSH score 3 was dominant among participants with short stature, lower Body mass index , and with higher levels of anti-tissue IgA, anti-tissue IgG, Higher levels of liver enzymes (ALT and AST) were associated significantly with short stature. There was a significant decrease in the mean level of liver enzymes after 3-6 months gluten-free diet.