Endocrine Abstracts

Introduction

The occurrence of thromboembolic events in celiac disease has been reported in the literature, especially in adults. The objective of our study is to determine the prevalence and clinical characteristics of thrombosis in celiac disease and to clarify the role of thrombophilic factors.

Patients and methods

This is a retrospective series of four observations of thrombosis among a cohort of 41 patients with celiac disease revealed in adulthood. Laboratory workup for acquired or constitutional thrombophilia was performed in all four cases.

Results

Between 2000 and 2014, celiac disease was diagnosed in 41 patients, among whom 5 cases of thrombosis were collected, for an overall prevalence of 12%. They were 4 women and 1 man with an average age of 43 years [18–61]. No patient had a family history of thrombosis. Thrombotic manifestations preceded the diagnosis of celiac disease in two cases. Two patients presented with two concomitant thrombotic locations: one had deep vein thrombosis of the left lower limb associated with portal thrombosis, the other had intracardiac thrombus and extensive portal thrombosis. The thrombosis was mesenteric-portal in the third case, cerebral in the fourth case and hepatic in the fifth case. Risk factors for thrombosis were identified in the five patients and could all be linked to celiac disease: hyperhomocysteinemia (n = 2), antiphospholipid antibodies (n = 1) and protein C and S deficiency (n = 2) linked to vitamin K deficiency, . The outcome in the three patients was good under anticoagulant treatment and a gluten-free diet.

Conclusion

The diagnosis of celiac disease should be made in case of unexplained thrombotic manifestations even in the absence of digestive signs. Risk factors for thrombosis can be acquired during this disease. These factors must be investigated, corrected, or even indicate thromboembolic prophylaxis.