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Deep Vein Thrombosis Revealing A "Silent" Coeliac Disease
Sofia Miranda1, Patrícia Clara2, Joana Rua2
1Internal Medicine Department, Hospital do Divino Espírito Santo, Ponta Delgada, Portugal.
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.
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