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Review
. 2020 Oct 6;20(1):327.
doi: 10.1186/s12876-020-01483-w.

Concurrent cerebral arterial and venous sinus thrombosis revealing celiac disease- a case report and literature review

Dalia Alhosain  1 , Lamia Kouba  2
Affiliations
Review

Concurrent cerebral arterial and venous sinus thrombosis revealing celiac disease- a case report and literature review

Dalia Alhosain et al. BMC Gastroenterol. .

Abstract

Background: Celiac disease is an autoimmune condition characterized by an inappropriate immune reaction against gluten. It classically presents as chronic diarrhea, bloating, and nausea in addition to malabsorption symptoms such as weight loss and micronutrient deficiency. We report the first case of coinciding cerebral infarction and venous sinus thrombosis unveiling the diagnosis of celiac disease.

Case presentation: A 40-year old female patient with a four-day history of severe diarrhea presented with right hemiplegia and altered mental status. Imaging revealed left middle cerebral artery occlusion and left transverse and sigmoid venous sinus thrombosis, along with left jugular vein thrombosis. Her laboratory evaluation was notable for profound iron deficiency anemia, thrombocytosis, and hyperhomocysteinemia. Her positive anti-tissue transglutaminase IgA antibodies and ensuing duodenal biopsy confirmed the diagnosis of celiac disease.

Conclusions: Celiac disease has a wide range of intestinal and extraintestinal manifestations and can present with thrombotic events in young patients with iron deficiency and hyperhomocysteinemia.

Keywords: Arterial thrombosis; Case report; Celiac disease; Stroke; Venous sinus thrombosis.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Axial MRI of the patient’s brain revealing a large hyper-intense area in the left parietal lobe corresponding to left middle cerebral artery (MCA) distribution (a; T2-weighted sequence, b; T2- weighted fluid-attenuated inversion recovery (FLAIR) sequence)
Fig. 2
Fig. 2
MRA of the patient’s brain revealing extensive left middle cerebral artery occlusion
Fig. 3
Fig. 3
MRV of the patient’s brain depicting the thrombosis of the left transverse and sigmoid sinuses and the left jugular vein
See this image and copyright information in PMC

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