1
|
Zouiter S, Bensabbahia D, Atrassi M, Abkari A. Cerebral Thrombophlebitis Complicating Coeliac Disease. Cureus 2024; 16:e66267. [PMID: 39238677 PMCID: PMC11375998 DOI: 10.7759/cureus.66267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/06/2024] [Indexed: 09/07/2024] Open
Abstract
Thromboembolic complications associated with coeliac disease are rare. They are dominated by abdominal venous thrombosis. However, cerebral thrombosis is exceptional. The research of the thrombotic risk factors is essential in coeliac disease. We report a clinical case illustrating cerebral thrombophlebitis due to antithrombin III deficiency with the presence of anticardiolipin antibodies complicating coeliac disease in a child.
Collapse
Affiliation(s)
- Siham Zouiter
- Pediatric Gastroenterology, Abderrahim El Harouchi Hospital, Ibn Rochd University Hospital, Casablanca, MAR
| | - Dalal Bensabbahia
- Pediatric Gastroenterology, Abderrahim Harouchi Mother-Child Hospital, University Hospital Center Ibn Rochd, Casablanca, MAR
| | - Meriem Atrassi
- Pediatric Gastroenterology, Abderrahim El Harouchi Hospital, Ibn Rochd University Hospital, Casablanca, MAR
| | - Abdelhak Abkari
- Pediatric Gastroenterology, Abderrahim El Harouchi Hospital, Ibn Rochd University Hospital, Casablanca, MAR
| |
Collapse
|
2
|
Furfaro F, Gabbiadini R, D'Amico F, Zilli A, Dal Buono A, Allocca M, Fiorino G, Danese S. Gastrointestinal System: COVID-19 and Potential Mechanisms Associated with Coagulopathy. Curr Drug Targets 2022; 23:1611-1619. [PMID: 36154571 DOI: 10.2174/1389450123666220922095913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 08/21/2022] [Accepted: 08/25/2022] [Indexed: 01/25/2023]
Abstract
SARS-CoV-2 is a novel coronavirus that expanded worldwide, generating a pandemic of acute respiratory syndrome called "coronavirus disease 2019" (COVID-19), which resulted in a global health crisis. The spectrum of COVID-19 manifestations ranges from none or mild symptoms to severe respiratory failure associated with systemic manifestations, mostly gastrointestinal symptoms. Hypercoagulability is an important feature of COVID-19 disease, which can potentially influence patients' prognosis. Therefore, gastroenterologists should focus on subjects with concomitant hypercoagulable gastrointestinal disorders as they may display a higher risk of thrombotic complications during SARS-CoV-2 infection. The aim of this review is to summarize the available evidence regarding the interplay of the prothrombotic pathogenetic mechanisms of both COVID-19 and hypercoagulable digestive diseases and the possible clinical implications. We summarized the potential interplay of prothrombotic mechanisms of both COVID-19 and hypercoagulable digestive diseases in the graphical abstract.
Collapse
Affiliation(s)
- Federica Furfaro
- Gastroenterology and Endoscopy, IRCCS Ospedale San Raffaele, Milan, Italy
| | | | - Ferdinando D'Amico
- Gastroenterology and Endoscopy, IRCCS Ospedale San Raffaele, Milan, Italy.,Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.,University Vita-Salute San Raffaele, Milan, Italy
| | - Alessandra Zilli
- Gastroenterology and Endoscopy, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Arianna Dal Buono
- IBD Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Mariangela Allocca
- Gastroenterology and Endoscopy, IRCCS Ospedale San Raffaele, Milan, Italy.,University Vita-Salute San Raffaele, Milan, Italy
| | - Gionata Fiorino
- Gastroenterology and Endoscopy, IRCCS Ospedale San Raffaele, Milan, Italy.,University Vita-Salute San Raffaele, Milan, Italy
| | - Silvio Danese
- Gastroenterology and Endoscopy, IRCCS Ospedale San Raffaele, Milan, Italy.,University Vita-Salute San Raffaele, Milan, Italy
| |
Collapse
|
3
|
Celiac Disease and Thrombotic Events: Systematic Review of Published Cases. Nutrients 2022; 14:nu14102162. [PMID: 35631302 PMCID: PMC9144428 DOI: 10.3390/nu14102162] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 05/13/2022] [Accepted: 05/16/2022] [Indexed: 02/04/2023] Open
Abstract
Extraintestinal manifestations of celiac disease (CD) should be considered, even in patients without typical intestinal symptoms. The aim of our study is to examine the literature regarding the occurrence of thrombotic events in CD, and to synthesize the data from case reports and case series. A systematic review of the literature was conducted by searching the Pub-Med/MEDLINE database, from the date of database inception to January 2022, to identify published cases and case series on this topic, in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A total of 55 cases were included in the study. The majority of patients were previously healthy individuals, with no comorbidities. In less than one-third of the cases (30.91%), the diagnosis of CD was established before the onset of thrombosis, while in the remaining cases (34.54%), thrombosis preceded the diagnosis or was diagnosed concomitantly with CD. The most common sites for thrombosis occurrence were hepatic veins (30.91%), while thrombosis of cerebral blood vessels, deep venous thrombosis of lower extremities, and pulmonary thromboembolism were less frequent. Thrombosis was most commonly isolated to one site only (78.18%). In 69.09% of cases (n = 38), some form of anticoagulation, along with a gluten-free diet, was initiated.
Collapse
|
4
|
Wiem R, Sondess A, Jihene C, Olfa J, Sonia H, Karima H, Fatma EA, Olfa B. Case Report: Cerebral venous thrombosis revealing celiac disease. F1000Res 2021; 10:680. [PMID: 34621513 PMCID: PMC8447050 DOI: 10.12688/f1000research.54233.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/06/2021] [Indexed: 12/02/2022] Open
Abstract
Celiac disease (CD) is an autoimmune enteropathy resulting from intolerance of an individual genetically predisposed to gluten. It has a large clinical polymorphism ranging from a classic digestive clinical presentation due to the malabsorption syndrome to extra-intestinal symptoms. Among the hematologic abnormalities, venous thromboembolic disease (VTE) has been reported, and they are most often located in the abdomen or lower limbs, but the cerebral localization was exceptionally described. We report a case of CD revealed by cerebral thrombophlebitis. A 44-year-old patient with no medical history and no drug intake, presented with hemiplegia followed by a status epilepticus in a context of apyrexia, initially hospitalized in intensive care. Magnetic imaging resonance displayed a cerebral venous thrombosis of the sigmoid sinus requiring anticoagulant treatment, then transferred to our department for the etiological investigation. On questioning, the patient reported chronic diarrhea and weight loss with no other associated symptoms. The examination revealed an underweight patient with pale conjunctiva, improvement of her deficit symptoms, and no other abnormalities. Laboratory tests noted biological signs of malabsorption. The thrombophilia assessment revealed a protein C deficiency with a slight increase in anticardiolipin antibodies and anti-Beta 2 glycoprotein 1 antibodies. Immunological tests noted positives anti-transglutaminase and IgA anti-endomysium antibodies. Duodenal biopsy demonstrated villous atrophy. After ruling out the other causes of VTE, the diagnosis of cerebral venous thrombosis secondary to CD was retained. Early diagnosis and treatment of CD improves the quality-of-life for patients and may spare them various long-term or even fatal complications.
Collapse
Affiliation(s)
- Romdhane Wiem
- Department of Endocrinology and Internal Medicine, Tahar Sfar University Hospital, Mahdia, 5100, Tunisia
| | - Arfa Sondess
- Department of Endocrinology and Internal Medicine, Tahar Sfar University Hospital, Mahdia, 5100, Tunisia
- Faculty of Medicine, University of Monastir, Monastir, 5000, Tunisia
| | - Chelly Jihene
- Department of Endocrinology and Internal Medicine, Tahar Sfar University Hospital, Mahdia, 5100, Tunisia
- Faculty of Medicine, University of Monastir, Monastir, 5000, Tunisia
| | - Jomaa Olfa
- Department of Endocrinology and Internal Medicine, Tahar Sfar University Hospital, Mahdia, 5100, Tunisia
| | - Hammami Sonia
- Faculty of Medicine, University of Monastir, Monastir, 5000, Tunisia
- Biochemistry Laboratory, LR12ES05 LR-NAFS Nutrition-Functional Food and Vascular Health, Faculty of Medicine, University of Monastir, Monastir, 5000, Tunisia
- Department of Endocrinology and Internal Medicine, Fattouma Bourguiba University Hospital, Monastir, 5000, Tunisia
| | - Hmida Karima
- Department of Radiology, Tahar Sfar University Hospital, Mahdia, 5100, Tunisia
| | - El Arbi Fatma
- Department of Endocrinology and Internal Medicine, Tahar Sfar University Hospital, Mahdia, 5100, Tunisia
- Faculty of Medicine, University of Monastir, Monastir, 5000, Tunisia
| | - Berriche Olfa
- Department of Endocrinology and Internal Medicine, Tahar Sfar University Hospital, Mahdia, 5100, Tunisia
- Faculty of Medicine, University of Monastir, Monastir, 5000, Tunisia
- Biochemistry Laboratory, LR12ES05 LR-NAFS Nutrition-Functional Food and Vascular Health, Faculty of Medicine, University of Monastir, Monastir, 5000, Tunisia
| |
Collapse
|
5
|
Wiem R, Sondess A, Jihene C, Olfa J, Sonia H, Karima H, Fatma EA, Olfa B. Case Report: Cerebral venous thrombosis revealing celiac disease. F1000Res 2021; 10:680. [PMID: 34621513 PMCID: PMC8447050 DOI: 10.12688/f1000research.54233.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/13/2021] [Indexed: 11/03/2023] Open
Abstract
Celiac disease (CD) is an autoimmune enteropathy resulting from intolerance of an individual genetically predisposed to gluten. It has a large clinical polymorphism ranging from a classic digestive clinical presentation due to the malabsorption syndrome to extra-intestinal symptoms. Among the hematologic abnormalities, venous thromboembolic disease (VTE) has been reported, and they are most often located in the abdomen or lower limbs, but the cerebral localization was exceptionally described. We report a case of CD revealed by cerebral thrombophlebitis. A 44-year-old patient with no medical history and no drug intake, presented with hemiplegia followed by a status epilepticus in a context of apyrexia, initially hospitalized in intensive care. Magnetic imaging resonance displayed a cerebral venous thrombosis of the sigmoid sinus requiring anticoagulant treatment, then transferred to our department for the etiological investigation. On questioning, the patient reported chronic diarrhea and weight loss with no other associated symptoms. The examination revealed an underweight patient with pale conjunctiva, improvement of her deficit symptoms, and no other abnormalities. Laboratory tests noted biological signs of malabsorption. The thrombophilia assessment revealed a protein C deficiency with a slight increase in anticardiolipin antibodies and anti-Beta 2 glycoprotein 1 antibodies. Immunological tests noted positives anti-transglutaminase and IgA anti-endomysium antibodies. Duodenal biopsy demonstrated villous atrophy. After ruling out the other causes of VTE, the diagnosis of cerebral venous thrombosis secondary to CD was retained. Early diagnosis and treatment of CD improves the quality-of-life for patients and may spare them various long-term or even fatal complications.
Collapse
Affiliation(s)
- Romdhane Wiem
- Department of Endocrinology and Internal Medicine, Tahar Sfar University Hospital, Mahdia, 5100, Tunisia
| | - Arfa Sondess
- Department of Endocrinology and Internal Medicine, Tahar Sfar University Hospital, Mahdia, 5100, Tunisia
- Faculty of Medicine, University of Monastir, Monastir, 5000, Tunisia
| | - Chelly Jihene
- Department of Endocrinology and Internal Medicine, Tahar Sfar University Hospital, Mahdia, 5100, Tunisia
- Faculty of Medicine, University of Monastir, Monastir, 5000, Tunisia
| | - Jomaa Olfa
- Department of Endocrinology and Internal Medicine, Tahar Sfar University Hospital, Mahdia, 5100, Tunisia
| | - Hammami Sonia
- Faculty of Medicine, University of Monastir, Monastir, 5000, Tunisia
- Biochemistry Laboratory, LR12ES05 LR-NAFS Nutrition-Functional Food and Vascular Health, Faculty of Medicine, University of Monastir, Monastir, 5000, Tunisia
- Department of Endocrinology and Internal Medicine, Fattouma Bourguiba University Hospital, Monastir, 5000, Tunisia
| | - Hmida Karima
- Department of Radiology, Tahar Sfar University Hospital, Mahdia, 5100, Tunisia
| | - El Arbi Fatma
- Department of Endocrinology and Internal Medicine, Tahar Sfar University Hospital, Mahdia, 5100, Tunisia
- Faculty of Medicine, University of Monastir, Monastir, 5000, Tunisia
| | - Berriche Olfa
- Department of Endocrinology and Internal Medicine, Tahar Sfar University Hospital, Mahdia, 5100, Tunisia
- Faculty of Medicine, University of Monastir, Monastir, 5000, Tunisia
- Biochemistry Laboratory, LR12ES05 LR-NAFS Nutrition-Functional Food and Vascular Health, Faculty of Medicine, University of Monastir, Monastir, 5000, Tunisia
| |
Collapse
|