Case Report

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

Table 1

Summary of published case reports on thrombosis associated with celiac disease.


Year of publicationAgeSexCountrySite of thrombosis AdmissionGI symptoms on admissionThrombosis risk factorsOrder of occurrence CommentTreatmentOutcome
HgbMCVPlt

1 
[9]
198737FUKMesenteric vein, PEn/an/a654YesSurgeryThrombosis firstIgA deficiency + RFGFDImproved, 
without recurrence

2 
[10]
199426FAlgeriaHepatic vein12685153YesNoneCD firstNoncompliant with GFDGFDLost in follow-up

3 
[10]
199440FAlgeriaHepatic vein, PVT12069450YesOCP use, MPDThrombosis firstInterruption of GFD followed by thrombosisGFD 
Long term Warfarin
Thrombosis reoccurred after stopping GFD despite anticoagulation

4 
[11]
199546FAlgeriaHepatic vein, PVT105107300NoMPDThrombosis firstLow levels of folic acid and vit B12GFDImproved

5 
[7]
199935MAustraliaDVT, PEn/an/an/aNoElevated homocysteine level, 
MTHFR mutation
Thrombosis firstLow folic acidGFD 
Heparin 
Warfarin 
Folic acid
n/a 
Plan to stop warfarin if homocysteine level normalizes

6 
[12]
200233MIsraelLV thrombus1071n/aYesElevated homocysteine level, low folic acid levelThrombosis firstRecurrent strokes in the setting of LV thrombusGFD 
Warfarin 
Folic acid
Improved

7 
[8]
200353MItalyDVT, PE108n/an/aNoElevated homocysteine level, low folic acid levelThrombosis firstBefore DVT multiple prior episodes of thrombophlebitisGFD 
Warfarin for 3 months
No recurrence in 1-year follow-up

8 
[13]
200319MSpainHepatic vein142n/a158YesNoneThrombosis firstHad significant ascites, low folic acidGFD 
Warfarin
No recurrence in 2-year follow-up

9 
[14]
200533FUSACentral retinal veinn/an/an/aNoPregnancy 
dehydration
CD firstPostpartumClopidogreln/a

10 
[15]
200640MUKMesenteric veinsn/an/a481YesProtein S deficiencyCD firstCoexisting Crohn’s diseaseGFDImproved

11 
[16]
200630FSaudi ArabiaSMV, PVT, splenic vein thrombosis73n/a518NoElevated homocysteine levelThrombosis firstFailed iron supplementationGFD 
Heparin 
Warfarin
Improved in 6 months’ follow-up

12 
[17]
200839FIndiaSplenic vein11n/a170NoElevated homocysteine levelThrombosis firstn/aGFD 
LMWH
Improved in 6 months’ follow-up

13 
[18]
200918MTunisiaDVT135n/a440NoProtein S deficiencyThrombosis firstSignificant weight gain with GFDGFD 
Warfarin
Improved, symptom-free 4 years after diagnosis

14 
[19]
200944MTurkeyDVT11.7n/an/aYesNoneCD firstn/aLMWH 
Warfarin
Improvement

15 
[20]
200919MIndiaHepatic vein6n/a175NoProtein C and S deficiencyThrombosis firstN/aLMWH 
Warfarin
Improvement in 10 months’ follow-up

16 
[21]
201026FUKCerebral vein thrombosisn/an/an/aNoNoneCD firstLane Hamilton syndromeUFHImprovement

17 
[22]
201230FIraqDVT5n/a950NoNoneThrombosis firstn/aGFD 
Warfarin
Improvement

18 
[23]
201627FJordanHepatic veinn/an/a145NoNoneCD firstThrombosis occurred despite compliance with GFDWarfarin 
portocaval shunt for ascites
Improved

19 
[24]
201735FTunisiaCerebral vein thrombosis9.4n/an/aNoOCP useThrombosis firstRecurrent cerebral vein thrombosis upon cessation of ACWarfarinImprovement

Hgb: hemoglobin (g/L), MCV: mean corpuscular volume, PLT: platelets (109/L), CD: celiac disease, DVT: deep venous thrombosis, OCP: oral contraceptive, GFD: gluten-free diet, PVT: portal vein thrombosis, AC: anticoagulation, SMV: superior mesenteric vein, LV: left ventricle, LMWH: low molecular weight heparin, and MTHFR: methyl-tetrahydrofolate reductase.