Celiac Disease Presenting As Budd Chari Syndrome

Abstract

An 11 year old female child presented with generalized body swelling, ascites and hepatomegaly. She had history of recurrent loose stools since last 5 years. Initial work up revealed ascites, and hepatomegaly. Serum proteins were within normal limits. Initial USG revealed isoechoeic space occupying lesion in segment VII of liver with ascites. USG Doppler revealed attenuation of blood flow in right hepatic vein. Ascites suddenly improved after 5 days, repeat USG revealed that all three hepatic veins and inferior vena cava were patent. CECT abdomen showed hemangioma measuring 2.1 X 2.6 X 1.36 cm in segment VII of liver with fatty liver with ascites with mesenteric lymphadenopathy. Serum tTGlevel carried out because of short stature and history of diarrhea was 372U/ml (normal 0-20 U/ml). Celiac disease was confirmed on biopsy. Hence the diagnosis of celiac disease with transient obstruction of hepatic veins due to hemangioma or thrombus. Keywords: Budd Chiari; Ascites; Celiac disease

Occurrence of Chronic Budd-Chiari Syndrome in a Patient with Coeliac Disease

“…16 The second case reported from India was in 2018 -an 11-year-old female diagnosed to have coeliac disease with transient hepatic vein obstruction, suspected to be due to a thrombus or hemangioma. 17 The third case was reported from India in 2019 in an 18-year-old female with a diagnosis of coeliac disease, well-controlled on a gluten-free diet, who presented with progressive ascites. On further evaluation, she was found to have elevated homocysteine levels and low serum folate.…”