Thromboembolic complications and cardiovascular events associated with celiac disease

Abstract

Celiac disease (CD) is a chronic intestinal immune-mediated disease occurring in genetically susceptible individuals who are exposed to gluten. Although it primarily affects the small intestine, CD has been associated with a wide spectrum of extraintestinal manifestations, including thromboembolism and cardiovascular events. The risk of ischemic stroke, myocardial infarction, and thromboembolism, such as deep vein thrombosis and pulmonary embolism, is higher in patients with CD, while there is accumulating evidence that gluten-free diet in CD patients decreases the risk of these complications. The pathogenetic mechanism of increasing hypercoagulability in CD is multifactorial and involves hyperhomocysteinemia due to malabsorption of vitamins B12, B6, and folic acid; endothelial dysfunction; acceleration of atherosclerosis; chronic inflammation; thrombocytosis; and thrombophilia. Therefore, in cases of thromboembolic complications and cardiovascular disease of obscure etiology, clinicians’ awareness of possible celiac disease is warranted.

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DKC and HM conceived, designed, and critically revised the study for important intellectual content;

FSF drafted the article, performed the research, and analyzed and interpreted the literature data for important intellectual content;

ETB and IVM performed the research, and analyzed and interpreted the literature data for important intellectual content, as well as contributed substantially in the manuscript preparation; all authors approved the final version of the article to be published.

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Correspondence to Dimitrios K. Christodoulou.

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Fousekis, F.S., Beka, E.T., Mitselos, I.V. et al. Thromboembolic complications and cardiovascular events associated with celiac disease. Ir J Med Sci 190, 133–141 (2021). https://doi.org/10.1007/s11845-020-02315-2

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Keywords

  • Atherosclerosis
  • Celiac disease
  • Extra-intestinal manifestations
  • Hypercoagulability
  • Thromboembolism