A Case of Celiac Disease with Pericardial Effusion

Abstract

Celiac disease is a unique enteropathic immune disorder and is now considered a distinct disease entity with protein manifestation and worldwide distribution. The deposition of immune complexes in the small intestine could be a possible reason for the extraintestinal autoimmune manifestations of Celiac disease. Pericardial effusion, though rare in adults, is likely a result of these autoimmune disorders related to Celiac disease. In present study case report, the authors present the case of a 67-year-old female patient with generalised oedema, anasarca, and pitting oedema in the lower extremities. Due to multiple episodes of vomiting, upper gastrointestinal endoscopy was performed, which revealed atrophic duodenal mucosa, and duodenal biopsies were taken from the second part of the duodenum (D2 biopsies). The possibility of Celiac disease was considered, and anti-deamidated gliadin peptide, Immunoglobulin A (IgA), and Immunoglobulin G (IgG) antibodies were sent. Celiac disease was diagnosed based on elevated serum levels of anti-deamidated gliadin peptide, IgA, and IgG antibodies, as well as histologic findings in the small bowel (duodenal biopsies D2). During the thorough evaluation, pericardial effusion was incidentally detected. Celiac disease is an autoimmune disorder in which exposure to gluten triggers inflammation in genetically predisposed individuals. The illness is estimated to have a prevalence of 2%, and most affected people remain undiagnosed. Pericardial effusion is a possible manifestation of Celiac disease, but there is currently no evidence that the disease directly causes the effusion.

Keywords

• anaemia
• immune disorder
• malabsorption
• oedema