Deep Venous Thrombosis and Bilateral Pulmonary Embolism Revealing Silent Celiac Disease: Case Report and Review of the Literature

Author:

Dumic Igor12ORCID,Martin Scott3,Salfiti Nadim4,Watson Robert5,Alempijevic Tamara67ORCID

Affiliation:

1. Department of Hospital Medicine, Mayo Clinic Health System, Eau Claire, WI, USA

2. Mayo Clinic College of Medicine and Science, Rochester, MN, USA

3. Department of Pathology, Mayo Clinic Health System, Eau Claire, WI, USA

4. Department of Gastroenterology and Hepatology, Mayo Clinic Health System, Eau Claire, WI, USA

5. Department of Family Medicine, Mayo Clinic Health System, Eau Claire, WI, USA

6. Department of Gastroenterology and Hepatology, Clinical Center of Serbia, Belgrade, Serbia

7. School of Medicine, Belgrade University, Belgrade, Serbia

Abstract

Celiac disease (CD) is a systemic, chronic autoimmune disease that occurs in genetically predisposed individuals following dietary gluten exposure. CD can present with a wide range of gastrointestinal and extraintestinal manifestations and requires lifelong adherence to a gluten-free diet [GFD]. Venous thromboembolism (VTE) as a presentation of celiac disease is unusual and rarely reported. We present a case of a 46-year-old man who was admitted for shortness of breath and pleuritic chest pain and was found to have iron deficiency anemia, deep venous thrombosis, and bilateral pulmonary emboli (PE). After work-up for his anemia, the patient was diagnosed with CD. Comprehensive investigation for inherited or acquired prothrombotic disorders was negative. It is becoming increasingly recognized that CD is associated with an increased risk for VTE. PE, however, as a presentation of CD is exceedingly rare and to the best of our knowledge this is the third case report of such an occurrence and the only case report of a patient from North America. It is important to recognize that the first symptoms or signs of celiac disease might be extraintestinal. Furthermore, VTE as a presentation of CD is rare but life-threatening.

Publisher

Hindawi Limited

Subject

General Engineering

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