Atypical Presentation of Celiac Disease in asymptomatic adult with no significant medical history : A rare diagnostic challenge

Background: Celiac disease mainly presents with gastrointestinal symptoms, but atypical presentations, including liver dysfunction, are increasingly recognized. Case Presentation: We report the case of a 49-year-old asymptomatic healthy gentleman, having mildly elevated cholesterol managed through healthy lifestyle. He had no history of alcohol or drugs intake and a negative family history of Celiac or liver disease. Patient was incidentally found to have markedly elevated liver transaminases on routine blood tests. Subsequent detailed workup for elevated liver transaminases including Celiac serology was normal. Conclusion: Celiac disease must be considered in the differential diagnosis of the patients with unexplained liver enzyme abnormalities without gastrointestinal symptoms and negative serological tests.