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| | Celiac hepatopathy (CH) [10, 11] | Glycogenic hepatopathy (GH) |
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| Clinically | Symptoms: asymptomatic, mild symptoms commonly malaise and fatigue, or symptoms of severe liver failure | Symptoms: mild epigastric pain, nausea, and vomiting |
| Signs: range from normal physical examination to liver failure | Signs: hepatomegaly ± tenderness |
| Liver enzymes: mild to moderate (less than 5 times the upper normal limit) | Liver enzymes: severe flares of transaminases reaching up to 2000–4000 U/L |
| Liver function panel: depends on the degree of liver injury | Liver function panel: normal |
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| Radiological | Abdominal ultrasound: normal to coarse echo texture associated with findings that suggest the activity or suspension of unrecognized CD as | Abdominal ultrasound |
| Hepatomegaly measured around (17–23 cm) bright coarse echotexture |
| (i) dilated small bowel loops | Abdominal CT scan: hepatomegaly and high-density and marked attenuation |
| (ii) enlarged mesenteric lymph nodes |
| (iii) increased peristalsis |
| (iv) abnormal jejunum folds |
| (v) enlarged mesenteric lymph nodes |
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| Histologically | Histological findings: | Histological findings: |
| (i) Nonspecific, most commonly periportal inflammation, mononuclear infiltration of the parenchyma, bile duct obstruction, hyperplasia of the Kupffer cells | (i) Swollen hepatocytes and pale cytoplasm |
| (ii) Steatosis | (ii) Abundant cytoplasmic glycogen deposits are demonstrated by periodic acid-Schiff (PAS) staining, and glycogen removal is demonstrated by diastase digestion |
| (iii) Less common, advanced lesions with fibrosis and liver cirrhosis. Fibrosis (all stages), and cirrhosis | (iii) No evidence of necrosis, inflammation, steatosis, or fibrosis |
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| Treatment prognosis | Strict gluten-free diet (GFD) | Glycemic control |
| (i) Can progress to fibrosis and cirrhosis | (i) No progression to fibrosis or cirrhosis |
| (ii) Reversible with strict GFD | (ii) Reversible with adequate glycemic control |
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| Duration needed for complete resolution clinically, radiological, and histologically | (i) Six months to one year | (i) Depends on the achievement of adequate glycemic control but can be as early as four to five weeks |
| (ii) Reversibility is considered pathognomonic to celiac hepatitis |
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