Department of Gastroenterology and Hepatology, School of Health Sciences, Faculty of Medicine, University Hospital of Ioannina, University of Ioannina, POBox 1186, 45110, Ioannina, Greece.
1st Department of Internal Medicine, School of Health Sciences, Faculty of Medicine, University Hospital of Ioannina, University of Ioannina, Ioannina, Greece.
Ir J Med Sci. 2021 Feb;190(1):133-141. doi: 10.1007/s11845-020-02315-2. Epub 2020 Jul 20.
Celiac disease (CD) is a chronic intestinal immune-mediated disease occurring in genetically susceptible individuals who are exposed to gluten. Although it primarily affects the small intestine, CD has been associated with a wide spectrum of extraintestinal manifestations, including thromboembolism and cardiovascular events. The risk of ischemic stroke, myocardial infarction, and thromboembolism, such as deep vein thrombosis and pulmonary embolism, is higher in patients with CD, while there is accumulating evidence that gluten-free diet in CD patients decreases the risk of these complications. The pathogenetic mechanism of increasing hypercoagulability in CD is multifactorial and involves hyperhomocysteinemia due to malabsorption of vitamins B12, B6, and folic acid; endothelial dysfunction; acceleration of atherosclerosis; chronic inflammation; thrombocytosis; and thrombophilia. Therefore, in cases of thromboembolic complications and cardiovascular disease of obscure etiology, clinicians' awareness of possible celiac disease is warranted.
乳糜泻（CD）是一种慢性肠免疫介导疾病，发生于接触麸质的遗传易感个体。尽管它主要影响小肠，但 CD 与广泛的肠外表现相关，包括血栓栓塞和心血管事件。CD 患者发生缺血性中风、心肌梗死和血栓栓塞（如深静脉血栓形成和肺栓塞）的风险更高，而越来越多的证据表明 CD 患者的无麸质饮食可降低这些并发症的风险。CD 中血液高凝状态增加的发病机制是多因素的，涉及由于维生素 B12、B6 和叶酸吸收不良导致的高同型半胱氨酸血症；内皮功能障碍；动脉粥样硬化加速；慢性炎症；血小板增多症和血栓形成倾向。因此，在血栓栓塞并发症和病因不明的心血管疾病的情况下，临床医生有必要意识到可能存在乳糜泻。
