Cerebral venous thrombosis as a rare thromboembolic complication of celiac disease: a case report.
Case report
Celiac disease complications
Cerebral venous thrombosis
Journal
European heart journal. Case reports
ISSN: 2514-2119
Titre abrégé: Eur Heart J Case Rep
Pays: England
ID NLM: 101730741
Informations de publication
Date de publication:
Oct 2020
Oct 2020
Historique:
received:
07
03
2020
revised:
24
03
2020
accepted:
11
06
2020
entrez:
18
11
2020
pubmed:
19
11
2020
medline:
19
11
2020
Statut:
epublish
Résumé
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. 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. 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.
Sections du résumé
BACKGROUND
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
METHODS
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
CONCLUSIONS
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.
Identifiants
pubmed: 33204951
doi: 10.1093/ehjcr/ytaa200
pii: ytaa200
pmc: PMC7649450
doi:
Types de publication
Case Reports
Langues
eng
Pagination
1-5Informations de copyright
© The Author(s) 2020. Published by Oxford University Press on behalf of the European Society of Cardiology.
Références
Ann Med. 2010 Dec;42(8):587-95
pubmed: 21070098
Stroke. 2004 Mar;35(3):664-70
pubmed: 14976332
Reumatologia. 2016;54(6):326-329
pubmed: 28115785
Br J Neurosurg. 2010 Dec;24(6):684-5
pubmed: 21070152
Am J Clin Nutr. 2007 Nov;86(5):1563S-8S
pubmed: 17991676
Neurosurg Focus. 2009 Nov;27(5):E6
pubmed: 19883208
J Gastroenterol Hepatol. 2016 Jul;31(7):1240-5
pubmed: 26709842
Ann Med. 2010 Dec;42(8):557-61
pubmed: 20883139
Cancer. 2012 Aug 1;118(15):3786-92
pubmed: 22169928
Acta Neurol Belg. 2017 Mar;117(1):341-343
pubmed: 27680734
Autoimmun Rev. 2014 Nov;13(11):1138-41
pubmed: 25149392
Am J Clin Nutr. 2007 Jan;85(1):160-6
pubmed: 17209192
Rev Esp Enferm Dig. 2008 Feb;100(2):102-3
pubmed: 18366270
Br J Haematol. 2007 Oct;139(1):121-7
pubmed: 17854316
Blood. 2007 Jan 15;109(2):412-21
pubmed: 16973955