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Dilated cardiomyopathy as the first presentation of coeliac disease: association or causation?

Peysh Patel1, Fraser Smith2, Niamh Kilcullen3

  • 1Leeds General Infirmary, Leeds, UK peysh@doctors.org.uk.

Clinical Medicine (London, England)
|April 8, 2018
PubMed

Insights

Coeliac disease can manifest as dilated cardiomyopathy, a heart muscle condition. Early diagnosis and multidisciplinary care are crucial for managing this rare presentation.

Area of Science:

  • Cardiology
  • Gastroenterology
  • Immunology

Background:

  • Dilated cardiomyopathy presents a clinical challenge in identifying causative mechanisms.
  • Coeliac disease is an autoimmune disorder triggered by gluten ingestion.

Observation:

  • A 19-year-old male presented with dilated cardiomyopathy as the initial clinical manifestation of undiagnosed coeliac disease.
  • Iron deficiency anaemia was a key indicator, prompting gastroenterological investigation and diagnosis.

Findings:

  • The case highlights a potential link between coeliac disease and dilated cardiomyopathy.
  • Pathophysiological mechanisms may involve nutritional deficiencies (e.g., iron) or autoimmune cross-reactivity leading to myocarditis.

Implications:

  • This case underscores the importance of considering gastrointestinal and autoimmune disorders in unexplained cardiomyopathy.
  • Early multidisciplinary team involvement is recommended for optimal patient management and diagnostic strategies.
  • Persistent ventricular dysfunction necessitates consideration for advanced cardiac care, including transplant evaluation.

Keywords:
Coeliac diseasecardiomyopathyheart failuremicronutrient deficiency

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