Dumic Igor, Martin Scott, Salfiti Nadim, Watson Robert, Alempijevic Tamara
Department of Hospital Medicine, Mayo Clinic Health System, Eau Claire, WI, USA.
Mayo Clinic College of Medicine and Science, Rochester, MN, USA.
Case Rep Gastrointest Med. 2017;2017:5236918. doi: 10.1155/2017/5236918. Epub 2017 Dec 12.
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.
乳糜泻（CD）是一种全身性慢性自身免疫性疾病，发生于具有遗传易感性的个体在饮食中接触麸质之后。CD可表现出广泛的胃肠道和肠外表现，需要终身坚持无麸质饮食（GFD）。静脉血栓栓塞（VTE）作为乳糜泻的一种表现并不常见，报道很少。我们报告一例46岁男性，因呼吸急促和胸膜炎性胸痛入院，发现患有缺铁性贫血、深静脉血栓形成和双侧肺栓塞（PE）。在对其贫血进行检查后，该患者被诊断为CD。对遗传性或获得性血栓前状态疾病的全面检查结果为阴性。越来越多的人认识到CD与VTE风险增加有关。然而，PE作为CD的一种表现极为罕见，据我们所知，这是此类情况的第三例病例报告，也是北美患者的唯一病例报告。认识到乳糜泻的首发症状或体征可能是肠外表现很重要。此外，VTE作为CD的一种表现虽然罕见但危及生命。
