Deep Venous Thrombosis and Bilateral Pulmonary Embolism Revealing Silent Celiac Disease: Case Report and Review of the Literature

Dumić, Igor; Martin, Silvia; Salfiti, Nadim; Watson, Robert J.; Alempijević, Tamara

doi:10.1155/2017/5236918

Cited by 15 publications

(17 citation statements)

References 40 publications

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“…With respect to thrombotic events, they can also be the prime manifestation of CD. Most cases report on venous thrombosis (deep venous thrombosis, pulmonary embolism, cerebral venous thrombosis, intraabdominal thrombosis), while arterial events have been rarely described [12,47,48,49,50]. In addition to case reports, an increased risk of venous thromboembolism has been shown in large cohort studies [51].…”

Section: Hemorrhagic and Thrombotic Eventsmentioning

confidence: 99%

Hematologic Manifestations in Celiac Disease—A Practical Review

et al. 2019

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Celiac disease (CD) is a systemic autoimmune disease driven by gluten-ingestion in genetically predisposed individuals. Although it primarily affects the small bowel, CD can also involve other organs and manifest as an extraintestinal disease. Among the extraintestinal features of CD, hematologic ones are rather frequent and consist of anemia, thrombocytosis (thrombocytopenia also, but rare), thrombotic or hemorrhagic events, IgA deficiency, hyposplenism, and lymphoma. These hematologic alterations can be the sole manifestation of the disease and should prompt for CD testing in a suggestive clinical scenario. Recognition of these atypical, extraintestinal presentations, including hematologic ones, could represent a great opportunity to increase the diagnostic rate of CD, which is currently one of the most underdiagnosed chronic digestive disorders worldwide. In this review, we summarize recent evidence regarding the hematological manifestations of CD, with focus on practical recommendations for clinicians.

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Section: Hemorrhagic and Thrombotic Eventsmentioning

confidence: 99%

Hematologic Manifestations in Celiac Disease—A Practical Review

et al. 2019

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“…Venous thromboembolism is a multifactorial condition that results from the co-existence of acquired and/or inherited predisposing factors acting cumulatively, including some clinical conditions, such as autoimmune and inflammatory disorders, inflammatory bowel disease and celiac disease [9], or risk factors such as an altered body mass index, platelet and white blood cell count. Hypercoagulable states, i.e., variants of genes involved in hemostasis displaying pro-coagulant effects, play a pivotal role in this respect [5].…”

Section: Introductionmentioning

confidence: 99%

Molecular Analysis of Prothrombotic Gene Variants in Venous Thrombosis: A Potential Role for Sex and Thrombotic Localization

Cernera

Minno

Amato

et al. 2020

JCM

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Background: Requests to test for thrombophilia in the clinical context are often not evidence-based. Aim: To define the role of a series of prothrombotic gene variants in a large population of patients with different venous thromboembolic diseases. Methods: We studied Factor V Leiden (FVL), FVR2, FII G20210A, Methylenetetrahydrofolate reductase (MTHFR) C677T and A1298C, beta-fibrinogen -455 G>A, FXIII V34L, and HPA-1 L33P variants and PAI-1 4G/5G alleles in 343 male and female patients with deep vein thrombosis (DVT), 164 with pulmonary embolism (PE), 126 with superficial vein thrombosis (SVT), 118 with portal vein thrombosis (PVT), 75 with cerebral vein thrombosis (CVT) and 119 with retinal vein thrombosis (RVT), and compared them with the corresponding variants and alleles in 430 subjects from the general population. Results: About 40% of patients with DVT, PE and SVT had at least one prothrombotic gene variant, such as FVL, FVR2 and FII G20210A, and a statistically significant association with the event was found in males with a history of PE. In patients with a history of PVT or CVT, the FII G20210A variant was more frequent, particularly in females. In contrast, a poor association was found between RVT and prothrombotic risk factors, confirming that local vascular factors have a key role in this thrombotic event. Conclusions: Only FVL, FVR2 and FII G20210A are related to vein thrombotic disease. Other gene variants, often requested for testing in the clinical context, do not differ significantly between cases and controls. Evidence of a sex difference for some variants, once confirmed in larger populations, may help to promote sex-specific prevention of such diseases.

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“…Other gastroenterological autoimmune conditions (such as Celiac disease [ 31 ] and inflammatory bowel disease [ 32 ]) are at an increased risk of venous thromboembolism; the genetic link between those disease is well established. If the hypercoagulability is confirmed in a future study, the genetic landscape of NAFLD patients has to be investigated to discover a possible link.…”

Section: Discussionmentioning

confidence: 99%

Prothrombotic and Inflammatory Markers in Elderly Patients with Non-Alcoholic Hepatic Liver Disease before and after Weight Loss: A Pilot Study

Gidaro

Manetti

Delitala

et al. 2021

JCM

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Background: Non-alcoholic fatty liver disease (NAFLD) is a pathological condition, ranging from fatty liver to chronic steatohepatitis (NASH), liver cirrhosis, and eventually to hepatocellular carcinoma. Recent findings suggest that patients with NAFLD have an increased risk of cardiovascular events and thromboembolism, which is independent of metabolic diseases that are frequently associated with NAFLD, such as diabetes, hyperlipidemia, and obesity. Methods: We evaluated 30 NAFLD patients, before and after weight loss. Plasma levels of C-reactive protein (CRP), fibrinogen, plasminogen activator inhibitor-1 (PAI-1), von Willebrand factor (VWF), homocysteine, coagulation protein S, Thrombin activable fibrinolysis inhibitor (TAFI), and factor VII (FVII) were assessed to evaluate whether they should be responsible of the prothrombotic state of NAFLD after weight loss. Results: At baseline, patients affected by NAFLD had a significantly higher levels of CRP, fibrinogen, PAI-1, VWF antigen, and FVII levels. After weight reduction, we observed a significant drop of inflammatory and prothrombotic markers, as well as glucometabolic, lipid profile. Conclusion: These findings provide evidence for a link between NAFLD/NASH and thromboembolism. The association seems to be linked with primitive thrombotic state and hypercoagulation due to increased levels of coagulation factors and reduced levels of PAI-1. This hypercoagulation state might explain increased levels of thrombosis and splanchnic thrombosis observed in NASH correlated cirrhosis.

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Deep Venous Thrombosis and Bilateral Pulmonary Embolism Revealing Silent Celiac Disease: Case Report and Review of the Literature

Cited by 15 publications

References 40 publications

Hematologic Manifestations in Celiac Disease—A Practical Review

Hematologic Manifestations in Celiac Disease—A Practical Review

Molecular Analysis of Prothrombotic Gene Variants in Venous Thrombosis: A Potential Role for Sex and Thrombotic Localization

Prothrombotic and Inflammatory Markers in Elderly Patients with Non-Alcoholic Hepatic Liver Disease before and after Weight Loss: A Pilot Study

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