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Case Reports in Gastrointestinal Medicine
Volume 2017 (2017), Article ID 5236918, 8 pages
https://doi.org/10.1155/2017/5236918
Case Report

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

1Department of Hospital Medicine, Mayo Clinic Health System, Eau Claire, WI, USA
2Mayo Clinic College of Medicine and Science, Rochester, MN, USA
3Department of Pathology, Mayo Clinic Health System, Eau Claire, WI, USA
4Department of Gastroenterology and Hepatology, Mayo Clinic Health System, Eau Claire, WI, USA
5Department of Family Medicine, Mayo Clinic Health System, Eau Claire, WI, USA
6Department of Gastroenterology and Hepatology, Clinical Center of Serbia, Belgrade, Serbia
7School of Medicine, Belgrade University, Belgrade, Serbia

Correspondence should be addressed to Igor Dumic; ude.oyam@rogi.cimud

Received 20 September 2017; Accepted 21 November 2017; Published 12 December 2017

Academic Editor: Warwick S. Selby

Copyright © 2017 Igor Dumic et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Celiac disease (CD) is a systemic, chronic autoimmune disease that occurs in genetically predisposed individuals following dietary gluten exposure. CD can present with a wide range of gastrointestinal and extraintestinal manifestations and requires lifelong adherence to a gluten-free diet [GFD]. Venous thromboembolism (VTE) as a presentation of celiac disease is unusual and rarely reported. We present a case of a 46-year-old man who was admitted for shortness of breath and pleuritic chest pain and was found to have iron deficiency anemia, deep venous thrombosis, and bilateral pulmonary emboli (PE). After work-up for his anemia, the patient was diagnosed with CD. Comprehensive investigation for inherited or acquired prothrombotic disorders was negative. It is becoming increasingly recognized that CD is associated with an increased risk for VTE. PE, however, as a presentation of CD is exceedingly rare and to the best of our knowledge this is the third case report of such an occurrence and the only case report of a patient from North America. It is important to recognize that the first symptoms or signs of celiac disease might be extraintestinal. Furthermore, VTE as a presentation of CD is rare but life-threatening.