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Kawasaki disease is a systemic vasculitis of unknown etiology. The most significant sequela of acute Kawasaki disease are related to information of small to medium sized arteries and, in particular, the development of coronary artery dilation and aneurysms (CAA). The aim of this study was to assess the cardiovascular complications of Kawasaki disease in Iran. The studied population consisted of 54 patients who were diagnosed to have Kawasaki disease and referred for cardiac evaluation. There were 30 boys and 24 girls, aged between 5 months and 13 years (Mean 3.9 years). All patients except 3 had received standard treatment with high-dose Aspirin and intravenous ? Globulin (IVGG). All patients were evaluated by physical exam, chest X-ray, ECG and echocardiography (ECHO). Abnormal cardiac findings included: Cardiomegaly in 4 (7.6%), ECG changes in 4 (7.6%), Mitral regurgitation in 3 (5.5%) LV dysfunction in 2 (3.7%), pericardial effusion in 4 (7.6%) and coronary artery dilatation in 5 (9.2%). Conclusion: 1) Kawasaki disease and its cardiovascular complications are not uncommon in Iran. 2) Coronary artery involvement is a major problem. 3) IVGG therapy reduces the risk of cardiac complications. 4) ECHO is a valuable tool in acute phase and follow-up period.

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It is generally recognized diabetes in more prevalent in women than men, besides that there is a close relationship between diabet, type of obesity and body fat distribution. In a descriptive-analytical study, 100 diabetic women aged 30-60 years old referring to diabetic clinic compared with 100 healthy subjects who were similar to the sample group with respect to age and sex. The results showed that BMI of majority women on both groups were in the range of 24.9-29.9, on the other hand 33% of women in control group and 26% patients suffered from the grade one obesity. Minimum ratio of waist-to-hip ratio (WHR) in patients was 0.72 and in healthy women was 0.47. In control group 90% and in healthy subjects 74% of women suffered from upper-truncal obesity (WHR>0.8). A significant difference was found (P=0.04) between the WHR ratio in women control and healthy group. To prevent the fat distribution in the area of stomach and upper truncal, increasing activity and dietary control are suggested.

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Liver is an important organ with major role in carbohydrates, proteins and lipids metabolism. In addition, secretion and excretion of toxic materials occur in this organ. Exposure to a variety of infectious agents such as parasitic, viral, bacterial or toxic materials may lead to liver damage. Today, one of the best way for investigation and diagnosis of liver damage is measurement of some liver enzyme such as Alanine Aminotransferase (GPT or ALT), Aspartate Aminotransferase (GOT or AST). Since, these enzymes exist in other tissues, measurement of other specific enzyme is required. In this study activity of Ornithine Carbamyltransferase (OCT), the second enzyme in urea cycle, in 56 patients with liver problem (Cirrhosis and viral hepatitis) was determined. SGPT, SGOT, Alb, Bil, ?GT and ALP tests were performed. To assess the health and unhealthy liver in both control and sample groups. Our data shows a correlation between activity of OCT with SGOT (R=0.782, P<0.001) and with SGPT (R=0.857, P<0.001). Since OCT enzyme is specific for liver, further investigation of activity of this enzyme in assessment of other liver problems is required.

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Background & Objective: Studies about the prevalence of Celiac disease (CD) in western Asian countries are scarce and there is only one study on the prevalence of CD in healthy blood donors in Iran. The aim of this study is to determine the prevalence of CD in general population of the city of Sari in north of Iran. Materials & Methods: This was a descriptive study and the blood samples were obtained from 1438 person from general population (686 males, 752 females: Mean age 35.5 range 18-66 year) of the Sari which were selected by stratified randomized sampling method during 2003. Total serum IgA was measured in all and IgA-deficient cases were excluded. From this study all cases were analyzed for IgA tissue transglutaminase antibody (Human recombinant tTG). All persons who had a positive serology for tTG-Ab underwent small intestinal biopsy. The biopsy samples were classified according to modified Marsh criteria. Results: All of the samples had normal total IgA. 13 cases showed positive IgA-tTG Ab (6 males and 7 females, mean age 37.5 yrs). All subjects with positive serology except one of them were found to have small bowel biopsies compatible with gluten sensitive enteropathy. One of 13 had Marsh 0, 8/13 Marsh I, 3/13 Marsh II and 1/13 showed Marsh IIIa lesion. Conclusion: The minimum prevalence of gluten-sensitivity among general population in north of Iran is 1/120. This data confirms our study on healthy blood donors, which has published previously and is like of prevalence of Celiac disease in western countries. So Celiac disease is not a rare disease as it thought before in this area.

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Background & Objective: Neural tube defects (NTDs) are a heterogenous group of malformation which is resulting from failure of normal neural tube closure between the 3rd and 4th week of embryonic development. The most common form of this malformation is anencephaly, spinabifida and ancephalocele. Prevalence of this malformation differs from geographic situation and race distribution. Materials & Methods: The aim of this study was to determine the prevalence and risk factors of NTDs in Birjand Hospital between 1996 to 2000. After diagnose of malformation among the 16785 infants born in the 2 hospitals in Birjand, reliable questionnaire was completed for the mothers who had malformed infants. The data was analyzed by SPSS software. Results: Prevalence of NTDs was 2.97 per 1000 birth, more higher than other countries anencephaly and spina bifida is common form of NTDs in this area. Consanguinity, previous abortion, malformed childbirth, malformed child in the family, diseases during pregnancy and winter delivery were some of the risk factors. Most of the mother (96%) didn’t take the Folic Acid during their pregnancy. Conclusion: The findings from this study indicate that the rate of NTD in Birjand is relatively higher comparing to other studies in different countries. Further investigations are recommended to find out the etiology of NTD in this area.

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Kikuchi-Fujimoto disease is a necrotizing Lymphadenitis with benign self-limit process in young women with fever, cervical lymphadenopathy and increased ESR with leukopenia. In this report we introduce 2 females with Kikuchi-Fujimoto disease. The first patient was a 31 years old lady with fever and unilateral cervical lymphadenopathy weight loss from 20 days age. In paraclinical findings ESR=50 mm/hr Hb=10 gr/dl. WBC count was 5300/µl bone marrow aspiration and biopsy with lymph node was done. The histopathologic diagnosis was Kikuchi-Fujimoto (Necrotizing Lymphadenitis). The 2nd patient was a lady with 35 years old and painful neck mass (Behind the sterno-clido mastoid) from 1.5-month age with fever and chill. In paraclinical findings ESR=52 mm/hr WBC 5500/µl, CRP++ lymph node biopsy was done the histopathologic diagnosis was Kikuchi-Fujimoto necrotizing Lymphadenitis. Therefore Kikuchi disease is a important differential diagnosis in young patients especially women with cervical lymphadenopathy and fever (FUO).

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Background&Objective: Hirschsprung's disease (H.D) is a congenital disease in which intestinal ganglionic cells are absent and can cause intestinal obstruction .The disease has various clinical manifestations and different length of bowel may be involved. Our aim was to study Hirschsprung’s clinical presentations and its rate of intestinal involvement in hospitalized patients in a 6-year course study in Rasht. The capital city of Gillan province in north of Iran. Materials&Methods: We studied the Hirschsprung’s patients referred to Poursina Referal Hospital between 1995-2001.A cross sectional descriptive- analytic study whose data was collected from patient’s files and questionnaires including demographic data, disease presentations, diagnostic methods, involved segment, surgical procedure types, surgical complications. Finally, the data was analyzed in SPSS10 software. Results: We detected 58 H.D in these 6 years, whome underwent surgery. There were 19 females and 39 males. Age of patients differed from one day to 18 year. Clinical findings were variable as follow: constipation (79.31%), abdominal distention (67.24%), inability to pass mecunium (17.24%), diarrhea (5.17%) and other less common manifestations. Pathologically, we divided our patients into 3 kinds: rectosigmoid, ultra short – segment, total – colonic. Surgeries were performed in three ways as follow Swenson - Soave - Lynn. Early complications, which come within one month after operation, contain anastomotic leakage (10.2%), prolonged constipation (10.2%). There were not any significant differences between these three types of surgical procedures. Conclusion: Majority of patients presented with a chronic course of constipation and abdominal distention. There wasn’t any difference between kinds of involvement and age and type of presentations. There are few associated anomalies in our patients. In some cases, surgical complications were less than other studies so, it is probable that our procedures had fewer complications or they had performed in appropriate time.

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Background&Objective: The proper treatment for early-stage Hodgkin’s disease is controversial. The purpose of this study was to evaluate the therapeutic outcomes of various treatment strategies in supradiaphragmatic clinical early-stage Hodgkin’s disease. Materials&Methods: This retrospective study reviewed the medical records of 105 eligible patients (49 stage I, 59 stage II) who were treated at radiotherapy- oncology departments of Qaem and Omid hospitals in Mashhad (Iran) from April 1995 to April 2000. 26 patients had B symptoms and 5 had large mediastinal mass. Treatment of patients consisted of chemotherapy alone (43 cases), radiotherapy alone (46 cases, 40 mantle and 6 Total nodal irradiation) and combined modality (16 cases). Survival rates were calculated by Kaplan- Meier model. Log-rank test was used to compare the survival profile between groups. Results: The median age of patients was 25 years with a male to female ratio of 1.56: 1. In comparison with radiotherapy only group, Primary chemotherapy and combined modality groups had significantly more cases with unfavorable factors such as B symptoms, Large mediastinal mass, ESR>40 and stage II. For chemotherapy, combined modality and radiotherapy groups the 5-year progression free survival was 72.5%, 82.5% and 56.2% (P<0.05) and the 5-year disease specific survival was 82.9%, 91.6% and 82.5% respectively. Conclusion: Despite having more cases with unfavorable factors, patients who underwent chemotherapy or combined treatment had lower relapse rates compared to radiotherapy only group. However, there was not a significant difference in 5-year disease specific survival rates between these groups.

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Background&Objective: The main cause of the cardiovascular disease is atherosclerosis of coronary artery. One of theraputic methods of the disease is coronary artery bypass graft (CABG). One of the main complicatons of CABG is bleeding after grafting. Different methods and proposed for preventing or reducting the bleeding. The aim of this study is to evaluate the effects of tranexamic acid (TA) on reduction of bleeding after grafting.

Materials&Methods: This study was a randomized clinical trial. 100 patients conditated to CBG divided into 2 groups randomizely (50 for control and 50 for subject). TA was injected to subject group twice with the same dosage of 15 mg/kg: first during the operation and second after ending the cardiopulmunary pomp and neutralizing the theraputic effect of heparin by protamin. The same method was used for the control group, except normal saline was used instead of TA variations such as bleeding rate, PT, aPTT were tested after CABG. The extracted data was analysed by SPSS software.

Results: The range of ages was 28 to 75 years and the control and subject groups were distributed normally from age viewpoint. Bleeding rate after grafting in subject group was 335±45 ml and in control group was 490±81 ml. in case and control platelet count and hematocrit groups, were significant differences (P<0.05).

Conclusion: Using TA during and after CABG is suggested to control bleeding.

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Background&Objective: Decrease in production of erythropoietin has been noted as one of the main factors causing anemia in ESRD patients, and administration of recombinant human erythropoietin (rhEPO) has been used to correct the anemia. Iron deficiency, including functional iron deficiency, limits the efficacy of rhEPO therapy in ESRD patients. This study examined the effects of maintenance intravenous iron sucrose (Venofer) on haemoglobin level and, optimization of erythropoietin therapy. Materials&Methods: Forty eight haemodialysis patients with haemoglobin level<9 gr/dl who were dialyzed three times weekly went under the study. Two thousands units of rhEPO were given subcutaneously at the end of each dialysis for seven weeks. At the end of the seventh week, those with haemoglobin level<9 gr/dl and with ferritin level <200 ng/dl (29 patients) were chosen for intravenous administration of 100 mg Venfor during the next five consecutive haemodialysis while maintaining the rhEPO dose at 2000 units with each dialysis. A week after the last dose of Venofer, haemoglobin and serum ferritin were determined. Results: Average haemoglobin level among the patients before administration of rhEPO was 7.5 gr/dl. After seven weeks of subcutaneous rhEPO at 2000 units with each haemodialysis, the average haemoglobin level raised to 8.5 gr/dl. The effect of maintenance IV Venofer was an increase in average haemoglobin level to 10.4 gr/dl. The same effect was seen on the ferritin level. The ferritin level of 131 ng/dl increased to 237 ng/dl a week after last dose of IV venofer. Conclusion: Intravenous (IV) iron improves haemoglobin response and, thus, optimizes rhEPO therapy.

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Background & Objective: The atherosclerosis of left anterior descending (LAD) coronary artery because of subtending more than 50% of left ventricular myocardial mass, has long been the focus of concern regarding appropriate treatment. This study aimed to evaluate efficacy of Percutaneous Transluminal Coronary Angioplasty (PTCA) with stenting for treatment of proximal LAD disease. Materials & Methods: In this descriptive study, 75 patients with isolated proximal LAD atherosclerotic lesion treated with PTCA and stenting were followed up for 9 months. The stenosis of all patients was documented by coronary angiography prior to enrollment. Exercise tolerance testing (ETT) by Bruce protocol was performed before angioplasty and at the end of follow up period as well. Results: There were 44 (58.7%) males, and 31 (41.3%) females. The mean age of patients was 59.4 (range, 39 to 83 yrs). Clinical outcomes of 73 (97.3%) patients were satisfactory. Only two patients developed re-stenosis during the follow up period. The first patient developed myocardial infarction at the 3rd day of her admission, and the second one had an abnormal ETT after 9 months. Percutaneous coronary revascularization with stenting was performed, and both of them were discharged without any problem. Conclusion: This study demostrated that the nine months prognosis of patients with isolated stenosis of proximal LAD coronary artery that treated by PTCA and stenting was acceptable. This treatment improves clinical status and results in lower hospital adverse event rates and in appropriate clinical outcome.

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Background & Objective: Chest pain is one of the most important and prevalent symptom in coroner artery diseases , in which the nurse has the key role in its management. This study was done to achieve the objective of assessment of the nurse's role in pain management in patients involved in coronery artery diseases. Materials & Methods: This descriptive study was done by the use of convenience sampling method in Vassaii hospital in Sabzevar city. 95 instances of chest pain were assessed by the nursed participated. In the research project. The tools used was a researcher – made check list and the nurse's role in different aspects, including the assessment of pain, relieve measures and reevaluating of the pain was studied. All the observations was recheck by third person. The Khowledge and perception of the nurses involved this research was studied by another technique prepared. Results: The most of the nurses put priority assessement on the location of pain and the assessment of other features of the pain did not get much attention, for assessing the verbal pain, the use of verbal descriptive was the main method and no one used the visual analog scale in pain intensity. In 92.6% of the instances the nurses practiced to relieve the pain and in most instances (96.8%) medication was used. The findings showed that in 41.1% instances, no specific reassessment was practiced. Conclusion: This study showed that altough the most nurses are aware of their part in relieving the patients pain but they do not fulfill this role in pain mamagement specially in assessing and reevaluating the pain.

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Background and Objective: Hemodialysis is one of the common therapulic proceduce for terminal renal failure. Insufficient and low efficient hemodialysis increases the mortality rate, therefore the assessment of hemodialysis efficacy is important. This study was done to determine the hemodialysis efficacy based on urea reduction ratio (URR) model and kt/v (Clearance Time Volume) criteria in Gorgan, Northern Iran. Materials and Methods: In this descriptive and analytical study 113 heomdilysis patients were selected prior to hemodilysis and five minutes after pump stopping, arterial blood urea nitrogen (BUN) was measured and then kt/v and URR were calculated. Also kt/v relations with weight, gender, educational level, length of hemodialysis session, blood flow rate, TMP (Terans Membran Presure), filter Ku/f (Clearance Ultrafiltration), preliminary disease, time of hemodialysis per week and the type of vessel access were determined. Data analyzed using SPSS-13 and independent t-test, chi-square, fisher exact test and Pearson correlation coefficient. Results: The mean of hemodilysis history was 37 months and mean of Patient's ages were 51.6 years. 77.9% of subjects had hemodialysis efficacy according to Kt/v and URR critrial. There was a statistical significant correlation between hemodialysis efficacy and time of hemodialysis session, blood flow rate, time of hemodialysis per week and type of vessels access (P<0.05), but there was not any significant correlation between hemodialysis efficacy and weight, gender, education, TMP, filter Ku/f and preliminary disease. Conclusion: This study suggested that hemodialysis efficacy in this center was better that other studies in Iran.

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Background and Objective: Systemic lupus erythematosus (SLE) is an inflammatory multi-system disease with an unknown origin. In patients with lupus disease cardiovascular events is an important cause of mortality and morbidity. This study carried out to measurement of high sensitivity C –reactive protein (HsCRP) and homocysteine in patients with SLE and their relation with diseases activity and cardiovascular risk factors.

Materials and Methods: This case control study carried out on 60 patients (55 females and 5 males) with lupus disease which referred to Clinical Research Center of Rheumatology, Mashhad, Iran and 30 controls (26 females and 4 males) during 2007-08. Information of subjects were gathered using SLEDAI questionare. HsCRP and homocysteine of subjects were measured. The level of low density lipoprotein (LDL), Triglycerid, hypertension and Body mass index (BMI) was assessed. Systemic lupus erythematosus activity was assessed by using SLEDAI so that if the score was higher than 10, lupus was called as active disease.

Results: Mean age was 28.8±10.3 and 33.8±9.13 years in SLE and control groups respectively. The mean of HsCRP in SLE patients were 3±2.42 mg/dl versus in controls were 1.58±2.1. The serum level of homocysteine were 12.3±1.93 µmol/L and 24±8.13 µmol/L in SLE patients and controls (P<0.001). Mean disease activity was 15.37. There was no any associtation between homocysteine and HsCRP and disease activity. LDL, Triglycerid, hypertension had significant association with homocystein (P<0.05). BMI and Triglycerid had significant association with HsCRP (P<0.05).

Conclusion: This study showed that there is no linear significant corrolation between homocysteine, HsCRP and disease activity, but there is significant corrolation between increase of homocysteine and HsCRP and cardiovascular risk factors.

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Background and Objective: Cardiovascular diseases is the first cause of mortality in developed and developing countries. This study was done to determine findings of coronary arteries angiography of subjects referring to Kosar angiography center in Golestan province, Iran.

Materials and Methods: In this descriptive study 5444 patients whome referred to the Kosar angiography center in Golestan province, Northern Iran undervent in this study during 2008-09. Gender, age, ethnicity, body mass index (BMI), cigarette smoking, opium, hypertension and coronary arteries angiography findings were completed for each subjects. Coronary arteries angiography was performed on 5400 of subjects. Data was analyzed by using SPSS-13, ANOVA, Chi-Square and Kruskal-Wallis tests.

Results: In this study 52% of subjects were men. 72% of patients were Native Fars. 49.5% of subjects were found to be illiterate. While 92.6% of clients did not reported any history of smoking, 22.5% of subjects were addicted to different opium. The mean BMI was 27.48 and 38.2% of clients reported a history of hypertension. Coronary arteries angiography was performed on 5400 of subjects. Coronary arteries disorders were determined in 3142 of subjects (58.8% males, 41.2% females). Left anterior descending, right coronary artery, circumflex and obtuse marginal were the most involved coronary arterial branches in positive angiograms, respectively.The most severe failure (47.7%) has been found in left anterior descending artery.

Conclusion: Due to high incidence of coronary arteries disease in this region of Iran, it is suggested to design a project to investigate the preventive mearsures of cardiovascular disorders.

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Background and Objective: Mucocutaneons manifestations are common in hemodialysis patients.The aim of this study was evaluate the prcvalence of cutaneous and mucosal manifestations in end stage renal disease (ESRD) patients who are on the maintenance hemodialysis.

Materials and Methods: This cross sectional study was performed on 100 (51 males, 49 females) hemodialysis patients in 5 Azar hospital in Gorgan, North of Iran during 2009. Patients selected on randomly based an all of them completely examined by a deramatologist for any changes in skin, hair, nail and mucous membrane. If necessary biopsy perform and refer to a pathologist. Data analysed with SPSS-13, mann-whitney, t-test, Chi-Square and Fisher tests.

Results: The average age was 49±12.3 years. The most common causes of ESRD was dibetes mellitus. The most common skin lesion was xerosis (78.3%), after that pruritis (39.1%) lentigo (34.8%) skin discoloration (32.6%) leukonychia (32%) thining of nail bed (24%) were common lesions. Lentigo was more common in female than male 42.85% vs 21.50% (p=0.042). Xerosis (p<0.01), scaling (p=0.042), lentigo (p<0.01), folliculitis (p<0.01), idio pathic guttate hypopigmentation (p<0.01) leukonychia (p<0.01) and half and half nail (p<0.01) have meaningful correlation with age. There was also meaningful correlation between dialyis duration and skin discoloration (p<0.031) and leukonychia (p<0.041). Clubhing and ca-p product also have meaningful correlation (p<0.027). Pruritis (p<0.048) and skin fungal infection (p<0.047) (tinea versi color) also have meaningful correlation with serum ferritin level.

Conclusion: Mucocutaneous manifestation were common in end stage renal disease patients.

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Background and Objective: Celiac is a hereditary disease presented with chronic inflammation of small intestine. Several studies supposed a relationship between Celiac disease and Inflammatory Bowel Disease (IBD). Tissue trans-glutaminase antibody is one of the best serological markers in Celiac disease. This study was designed to evaluate the association of Celiac and IBD using tissue trans-glutaminase antibody.

Materials and Methods: In this descriptive study 127 confirmed IBD patients who were referred by gastroentrologists 2005-08 enrolled into the study. A questionnaire was completed and tissue trans-glutaminase antibody was evaluated with ELISA method with a Cut-off=12 U/ml.

Results: Among 127 referred patients, serum samples of 102 patients were collected. Mean±SD of age was 36.17±15.2 years and 48% were males. Ulcerative colitis, Crohn’s disease and other colitis were observed in 76 (74.5%), 7 (6.9%) and 19 (18.6%) of patients, respectively. Tissue trans-glutaminase antibody was positive (19.8 U/L) in one 46-years-old male patient with ulcerative colitis.

Conclusion: Tissue trans-glutaminase antibody titer was not significantly different between IBD patients and controls, thus it seems not appropriate to suggest as one of the routine tests in IBD patients.

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Background and Objective: Lead threaten living creature’s life as air pollutant and causes several diseases such as degenerative disease of nervous system. This research was conducted to determine the effect of Curcumin on BDNF changes and oxidative/antioxidative process in rat’s hippocampus which exposed to Lead acetate.

Materials and Methods: In this experimental study, 40 male Wistar rats were randomly assigned to four groups of ten: Base, Sham(control), lead and Curcumin+Lead. lead and Curcumin+Lead groups received 20 mg/kg lead acetate and Curcumin+Lead group also received 30 mg/kg Curcumin, peritoneally for 8 weeks (3 days in weeks). MDA (oxidative stress biomarker) and TAC (total antioxidative capacity) levels were measured by TBARS and FRAP methods, respectively, and hippocampus BDNF level was measured by ELISA method in rat hippocampus region. Data was analyzed by one-way ANOVA test and Tukey at P<0.05 level.

Results: Injection of lead acetate significantly increased MDA, non-significantly decreased hippocampus BDNF and significantly decreased TAC levels in the Lead group compared with control groups. On the other hand, curcumin administration led to non significantly decreased MDA, nonsignificantly increased BDNF and significantly increased TAC levels compared with other groups (P<0.05).

Conclusion: This study showed that Curcumin adminstration in long term lead acetate-treated male Wistar Rats did not increased BDNF of hippocampus, but it prevent the reduction of BNDF due to lead-intoxification.

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Background and Objective: Legg-Calve-Perthes disease is one of the most common disabling diseases of childhood and if not managed appropriately is truly disabling. Severity of disease and duration of disease onset are main determinants of choosing treatment strategy of either conservative management or surgical treatment. This study was designed to determine Legg-Calve-Perthes treatments and relation between type of treatment and duration of the disease.

Materials and Methods: This descriptive study was carreid out on 50 patients with Legg-Calve-Perthes disease admitted in Ghaem Hospital in Mashhad, North East of Iran from 1995-2005.

Results: According to age of patients and severity of disease, the subjects allocated to conservatine (11 patients) and surgical treatment (39 patients). Clinical improvment signs include pain reduction, range of joints motion, which were avaluate by physical examination and taking medical history of patients. In conservative group, only 4 patients assumed to be successfully treated with mean age of 7.25 years and the mean interval between disease onset and beginning of treatment was 2.25 months. Surgical group had mean age of 10.85 years and mean interval between onset of disease and initiation of treatment was 18 months. Conservative group showed less sever form of disease (lateral pillar group A and group B with age less than 8 years), but patients treated surgically were more severely involved (lateral pillar group B with age more than 8 years and group C).

Conclusion: This study showed that age and severity of disease (lateral pillar classification) are main elements in treatment strategy (choosing conservative VS surgical treatment). The interval between onset of disease and onset of treatment strongly affects treatment success.

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Celiac disease is one of the most common cause of malabsorbtion syndrom. The symptom of this disease associated secondary to malabsorbtive problems. Celiac can be accompanied with liver enzyme dysfunction with various extra intestinal findings. This case was a 27-year old man presented with abnormal liver function test over period of 1 year. He did not have another symptom such as diarrhea, weight loss or skin lesion. In medical examination, there was no ascites, peripheral edema or jaundice. Diagnostic re-examination of the paitent include serology tests and Viral hepatitis, Wilson disease and auto Imuune respones showed to be normal. Abdominal and biliary sonography had normal results. Liver biopsy revealed no sign of any pathology, but duodenal biopsy and serologic findings were compatible by Celiac disease. The symptom improved on a gluten-free diet and his liver enzyme function tests became normal subsequently.