Cerebral venous thrombosis as a rare thromboembolic complication of celiac disease: a case report
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Maha Bouziane1, Salim Arous1, Rachida Habbal1
1Cardiology Department, P37, Ibn Rochd University Hospital, 1, Rue des Hôpitaux, Quartier des Hôpitaux, Casablanca, Morocco.
Insights
Celiac disease can lead to serious complications like cerebral venous thrombosis, a rare but life-threatening condition. Prompt anticoagulation therapy offers a favorable outcome for patients with this condition.
Area of Science:
- Neurology
- Gastroenterology
- Hematology
Background:
- Celiac disease is an inflammatory syndrome linked to coagulation abnormalities and thromboembolic events.
- Cerebral venous thrombosis is a rare but severe complication of celiac disease.
- Patients with celiac disease face an increased risk of hypercoagulability.
Background:
Celiac disease is a digestive inflammatory syndrome with several complications. It is associated with coagulation and platelets abnormalities leading to thromboembolic events. Cerebral venous thrombosis is an exceptional localization of thrombosis in celiac disease and could be life-threatening.
Case Summary:
A 17-year-old female patient with history of celiac disease and not following a gluten-free diet, checked in to the emergency department for a sudden, 2-week-old, and deteriorating, onset of intense headache and muscle weakness. The cerebral computed tomography-scan showed bilateral fronto-parietal hypodensity with micro-bleeds. We investigated using a cerebral magnetic resonance imaging that revealed superior longitudinal sinus thrombosis and right transverse and sigmoid sinuses thrombosis, along with right haematoma and ischaemic areas. The patient was prescribed anticoagulation therapy. Follow-ups over a 2-year period confirmed a favourable outcome and a complete regression of symptoms.
Discussion:
Evolution of celiac disease could be associated with several complications. Eighty-five percent of patients is potentially exposed to thromboembolic events due to the hypercoagulability state of the disease and different coagulation and fibrinolysis abnormalities (e.g. hyperhomocysteinaemia, protein C and S deficiencies, vitamin K and B deficiencies). Cerebral venous thrombosis is a rare thromboembolic localization. Anticoagulation is efficient in most cases though endovascular treatment might be required.
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