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Celiac disease with Budd-Chiari syndrome: A rare association
Durga Shankar Meena1, Vikram Singh Sonwal1, Gopal Krishna Bohra1
1Department of Internal Medicine, All India Institute of Medical Sciences, Jodhpur, India.
Insights
Budd-Chiari syndrome, a liver condition, was diagnosed in an 18-year-old with celiac disease. Treatment with anticoagulants and a gluten-free diet led to significant symptom improvement.
Area of Science:
- Hepatology
- Gastroenterology
- Vascular Medicine
Background:
- Budd-Chiari syndrome involves obstruction of hepatic venous outflow.
- Celiac disease is an autoimmune disorder triggered by gluten.
Observation:
- An 18-year-old female with known celiac disease presented with abdominal distention and shortness of breath.
- Computed tomography confirmed hepatic vein obstruction, leading to a Budd-Chiari syndrome diagnosis.
Findings:
- The patient exhibited elevated homocysteine levels and decreased serum folate.
- Treatment with oral anticoagulants and a gluten-free diet resulted in significant clinical improvement, including reduced ascites, within 4 weeks.
Implications:
- This case highlights a rare association between Budd-Chiari syndrome and celiac disease.
- Elevated homocysteine and low folate may play a role in this association.
- Budd-Chiari syndrome should be considered in celiac disease patients with unexplained ascites.
Abstract:
Budd-Chiari syndrome is characterized by hepatic venous outflow tract obstruction. We describe an 18-year-old female of known celiac disease presented with progressive abdomen distention and shortness of breath for the last 1 month. Computed tomography of abdomen revealed hepatic vein obstruction. The patient was diagnosed with Budd-Chiari syndrome. Coagulation profile showed an increased homocysteine level. Serum folate level was also decreased. The patient was put on oral anticoagulant with a gluten-free diet. After 4 weeks, the patient showed significant improvement with decreased ascites. The association of Budd-Chiari syndrome with Celiac disease has not yet been fully understood. There have been few reports that described this rare association. Budd-Chiari syndrome should be considered as an important differential in a patient with unexplained ascites and celiac disease.
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