Cerebral venous thrombosis as a rare thromboembolic complication of celiac disease: a case report

• Published in: European heart journal : case reports Vol. 4; no. 5; pp. 1 - 5
• Main Authors: Bouziane, Maha, Arous, Salim, Habbal, Rachida
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01-10-2020
• Subjects: Case Reports; Celiac disease complications; Case report; Cerebral venous thrombosis
• DOI: 10.1093/ehjcr/ytaa200
• EISSN: 2514-2119

Celiac disease is a digestive inflammatory syndrome with several complications. It is associated with coagulation and platelets abnormalities leading to thromboembolic events. Cerebral venous thrombosis is an exceptional localization of thrombosis in celiac disease and could be life-threatening.
A 17-year-old female patient with history of celiac disease and not following a gluten-free diet, checked in to the emergency department for a sudden, 2-week-old, and deteriorating, onset of intense headache and muscle weakness. The cerebral computed tomography-scan showed bilateral fronto-parietal hypodensity with micro-bleeds. We investigated using a cerebral magnetic resonance imaging that revealed superior longitudinal sinus thrombosis and right transverse and sigmoid sinuses thrombosis, along with right haematoma and ischaemic areas. The patient was prescribed anticoagulation therapy. Follow-ups over a 2-year period confirmed a favourable outcome and a complete regression of symptoms.
Evolution of celiac disease could be associated with several complications. Eighty-five percent of patients is potentially exposed to thromboembolic events due to the hypercoagulability state of the disease and different coagulation and fibrinolysis abnormalities (e.g. hyperhomocysteinaemia, protein C and S deficiencies, vitamin K and B deficiencies). Cerebral venous thrombosis is a rare thromboembolic localization. Anticoagulation is efficient in most cases though endovascular treatment might be required.