深静脉血栓形成揭示“隐匿性”腹腔疾病
Deep Vein Thrombosis Revealing A "Silent" Coeliac Disease.
作者信息
Miranda Sofia, Clara Patrícia, Rua Joana, Cimbron Miriam, Salvador Fernando
机构信息
Internal Medicine Department, Hospital do Divino Espírito Santo, Ponta Delgada, Portugal.
Internal Medicine Department, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, Portugal.
出版信息
Eur J Case Rep Intern Med. 2023 Aug 18;10(9):003977. doi: 10.12890/2023_003977. eCollection 2023.
INTRODUCTION
We present a clinical case of a 45-year-old man with recurrent deep vein thrombosis (DVT) and multiple hospital admissions due to severe infectious conditions. A newfound hypoalbuminemia raised the suspicion of a protein-losing condition, with an upper endoscopy revealing lesions at the D2 level compatible with coeliac sprue and HLA typing positive for both DQ-2 and DQ-8.
METHODS
A gluten free diet was started and apixaban was suspended.
RESULTS
No new complications were reported.
DISCUSSION
Multiple mechanisms are believed to be behind the association between DVT and coeliac disease. However, to this date, no consensus exists regarding the ideal duration of anticoagulation.
LEARNING POINTS
Coeliac disease should always be considered a systemic disease.Thromboembolism is a possible extraintestinal manifestation of coeliac disease.Coeliac disease should be considered as a possible cause of thromboembolism even in the absence of gastrointestinal symptoms, which it can precede by several years.
引言
我们报告一例45岁男性临床病例，该患者反复发生深静脉血栓形成（DVT），并因严重感染性疾病多次住院。新发现的低白蛋白血症引发了对蛋白丢失性疾病的怀疑，上消化道内镜检查显示十二指肠第二段水平的病变符合乳糜泻，且HLA分型显示DQ-2和DQ-8均为阳性。
方法
开始无麸质饮食，并停用阿哌沙班。
结果
未报告新的并发症。
讨论
DVT与乳糜泻之间的关联背后存在多种机制。然而，迄今为止，关于抗凝的理想持续时间尚无共识。
学习要点
乳糜泻应始终被视为一种全身性疾病。血栓栓塞是乳糜泻可能的肠外表现。即使没有胃肠道症状，乳糜泻也应被视为血栓栓塞的可能原因，其可在胃肠道症状出现前数年发生。
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