Atrioventricular Block in Celiac Disease: An Unusual Clinical Presentation in a Child. A Case-Based Review

Area of Science:

• Pediatric Cardiology
• Gastroenterology
• Autoimmune Disorders

Background:

• Atrioventricular block (AVB) is rare in children, while celiac disease (CeD) is a common autoimmune disorder.
• Cardiac manifestations of CeD, including conduction disease, are primarily reported in adults, often preceding or accompanying gastrointestinal symptoms.
• Rare instances of AVB associated with CeD have been documented, particularly with extra-cardiac CeD involvement.

Observation:

• A 4-year-old child presented with progressive acquired atrioventricular block (AVB).
• Celiac disease (CeD) was diagnosed in this child after the onset of AVB.
• The patient experienced significant improvement in AVB grade following the initiation of a strict gluten-free diet.

Findings:

• A strict gluten-free diet led to rapid and substantial improvement in acquired atrioventricular block (AVB) in a pediatric patient.
• This case highlights a potential link between celiac disease (CeD) and acquired AVB in children.
• The findings suggest that CeD may be an underlying cause of AVB in some pediatric cases.

Implications:

• Consider screening for celiac disease (CeD) in all children diagnosed with acquired atrioventricular block (AVB).
• Early diagnosis and dietary management of CeD may help reverse or improve cardiac conduction abnormalities like AVB.
• This approach could prevent the need for more invasive cardiac interventions in affected children.