Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2025 Aug;45(8):e70206.
doi: 10.1111/liv.70206.

Liver Involvement in Celiac Disease and Immune-Mediated Diseases of the Small Bowel

Nicoletta Nandi  1   2 , Elena F Verdu  3 , Detlef Schuppan  4 , Andres Jose Gomez-Aldana  5 , Maria Ines Pinto-Sanchez  3 , Francesco Simone Conforti  1 , Marco Maggioni  6 , Flavio Caprioli  1   2 , Luca Elli  1   2
Affiliations
Review

Liver Involvement in Celiac Disease and Immune-Mediated Diseases of the Small Bowel

Nicoletta Nandi et al. Liver Int. 2025 Aug.

Abstract

Disorders of the hepatobiliary system are commonly associated with gastrointestinal (GI) diseases. The GI and hepatobiliary systems interact through the portal vein system and enterohepatic circulation, creating a gut-liver axis that allows for a complex multidirectional interplay between immune, hormonal, dietary and environmental luminal factors that include the gut microbiota. This interaction may underlie the liver affection in autoimmune and immune-mediated small bowel diseases through a variety of pathways that include autoimmune, metabolic, immune-mediated, and/or iatrogenic mechanisms. Despite evidence of a gut-liver axis and co-morbid liver associations with small bowel diseases, the clinical implications and how these conditions should be clinically managed remain unclear. In this narrative review, we describe the hepato-biliary manifestations associated with chronic immune-mediated enteropathies of the small bowel in adults, with particular focus on CeD and Crohn's disease.

Keywords: Crohn's disease; autoimmune hepatitis; celiac disease; small bowel.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Most frequent liver diseases associated to celiac disease and Crohn's disease.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Schiepatti A., Sanders D. S., Baiardi P., et al., “Nomenclature and Diagnosis of Seronegative Coeliac Disease and Chronic Non‐Coeliac Enteropathies in Adults: The Paris Consensus,” Gut 71 (2022): 2218–2225. - PMC - PubMed
    1. Pinto‐Sanchez M. I., Seiler C. L., Santesso N., et al., “Association Between Inflammatory Bowel Diseases and Celiac Disease: A Systematic Review and Meta‐Analysis,” Gastroenterology 159 (2020): 884–903.e31. - PubMed
    1. Roggenbuck D., Goihl A., Sowa M., et al., “Human Glycoprotein‐2 Expressed in Brunner Glands—A Putative Autoimmune Target and Link Between Crohn's and Coeliac Disease,” Clinical Immunology 247 (2023): 109214. - PubMed
    1. König J., Wells J., Cani P. D., et al., “Human Intestinal Barrier Function in Health and Disease,” Clinical and Translational Gastroenterology 7 (2016): e196. - PMC - PubMed
    1. Majumdar K., Sakhuja P., Puri A. S., Gaur K., Haider A., and Gondal R., “Coeliac Disease and the Liver: Spectrum of Liver Histology, Serology and Treatment Response at a Tertiary Referral Centre,” Journal of Clinical Pathology 71 (2018): 412–419. - PubMed

MeSH terms

LinkOut - more resources