Severe Alveolar Hemorrhage – What’s in it for the Gastroenterologist?

Abstract

Although the association is rare, celiac disease should be considered in a patient with idiopathic pulmonary hemosiderosis. In our case, severe anemia and alveolar infiltrates markedly improved with glucocorticoids and gluten-free diet.

Physicians’ attitude and perception regarding celiac disease: A questionnaire-based study

“…Approximately 40% of the patients with newly diagnosed CD might have elevated liver blood enzymes, and, gener-ally, their normalization is seen under a proper gluten-free diet (27). Occurrence of symptomatology dominated by constipation or complications, such as pulmonary hemosiderosis, infertility, or ataxia, is much less commonly encountered (1,28).…”

Lane-Hamilton Syndrome: An Illustration of Extraintestinal Manifestations of Celiac Disease

“…17,18 More rare presentations include headaches, ataxia, neuropathy, and seizures with bilateral occipital calcifications, osteopenia and osteoporosis, celiac crisis with profuse diarrhea, hyposplenism, infertility, dermatitis herpetiformis, and alopecia. 17,18,21,22 Hemorrhagic events, such as gastrointestinal hemorrhage, hematuria, epistaxis, and LHS, are uncommon presentations of CD. 19,22 The exact mechanism of the various manifestations of CD remains unclear.…”

Hemorrhagic Events in Adult Celiac Disease Patients. Case Report and Review of the Literature

“…In the remainder, data on coagulation tests were not available. For the coagulopathy treatment, vitamin K [4,9,12,28,29,32,[46][47][48][49][50], fresh frozen plasma [9,12] or coagulation factors [46] were administered.…”

“…Also, in eight cases the improvement was established after biopsy, when histological amelioration/ restoration under GFD was noted [9, 18, 26-28, 32, 49, 51]. In other cases, different parameters were described to support the favorable response under GFD, such as: clinical improvement [8, 10, 12-14, 17, 24, 35, 36, 47], increase in hemoglobin levels [12-14, 35, 36, 37, 52, 53], pulmonary recovery [12,14,36] and weight gain [13,14,46,[52][53][54].…”