Spontaneous recovery of isolated advanced heart block in patient with celiac disease by starting a strict gluten free diet: a case report and review of the literature
  • Ossama Maadarani
    Critical Care Unit, Internal Medical Department, Ahmadi Hospital—Kuwait Oil Company, Kuwait
  • Leila Bigdelu
    Cardiovascular Medicine Division, Vascular Surgery Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
  • Zouheir Bitar
    Critical Care Unit, Internal Medical Department, Ahmadi Hospital—Kuwait Oil Company, Kuwait
  • Mohammad Alhabibi
    Critical Care Unit, Internal Medical Department, Ahmadi Hospital—Kuwait Oil Company, Kuwait
  • Hosni Kabbara
    Critical Care Unit, Internal Medical Department, Ahmadi Hospital—Kuwait Oil Company, Kuwait

Keywords

Complete heart block, celiac disease, malabsorption

Abstract

Cardiac conduction disorder may have a wide range of aetiology and can manifest with symptomatic bradycardia and syncope. Celiac disease is a malabsorptive long-term autoimmune disorder where the small intestine is the primarily affected organ due to gluten intolerance in genetically predisposed individuals. The associations between celiac disease and cardiac pathology are uncommon. We report a case of a 50-year-old woman with a known case of celiac disease who presented with a symptomatic cardiac conduction abnormality that improved with a gluten-free diet.

VIEW THE ENTIRE ARTICLE

References

  • Rubio-Tapia A, Hill ID, Kelly CP, Calderwood AH, Murray JA; American College of Gastroenterology. ACG clinical guidelines: diagnosis and management of celiac disease. Am J Gastroenterol 2013;108:656–76.
  • Pinto-Sanchez MI, Silvester JA, Lebwohl B, Leffler DA, Anderson RP, Therrien A, et al . Society for the Study of Celiac Disease position statement on gaps and opportunities in coeliac disease. Nat Rev Gastroenterol Hepatol 2021;18:875–884.
  • Oberhuber G, Granditsch G, Vogelsang H. The histopathology of coeliac disease: time for a standardized report scheme for pathologists. Eur J Gastroenterol Hepatol 1999;11:1185–1194.
  • Caio G, Volta U, Sapone A, Leffler DA, De Giorgio R, Catassi C, et al. Celiac disease: a comprehensive current review. BMC Med 2019;17:1–20.
  • Conroy M, Allen N, Lacey B, Soilleux E, Littlejohns T. Association between coeliac disease and cardiovascular disease: prospective analysis of UK Biobank data. BMJ Med 2023 Jan 4;2:e000371
  • Ciaccio EJ, Lewis SK, Biviano AB, Iyer V, Garan H, Green PH. Cardiovascular involvement in celiac disease. World J Cardiol 2017;9:652–666.
  • Sari C, Ertem AG, Sari S, Efe TH, Keles T, Durmaz T, et al. Impaired aortic function in patients with coeliac disease. Kardiol Pol 2015;73:1108-1113 [PMID: 25987403 DOI: 10.5603/ KP.a2015.0097]
  • Korkmaz H, Sozen M, Kebapcilar L. Increased arterial stiffness and its relationship with inflammation, insulin, and insulin resistance in celiac disease. Eur J Gastroenterol Hepatol 2015;27:1193–1199.
  • Bayar N, Cagirci G, Üreyen CM, Kus G, Kücükseymen S, Arslan S. The relationship between spontaneous multi-vessel coronary artery dissection and celiac disease. Korean Circ J 2015;45:242–244.
  • Heikkilä K, Koskinen OA, Agarwal A, Tikkinen KAO, Mäki M, Kaukinen K. Associations of coeliac disease with coronary heart disease and cerebrovascular disease: A systematic review and meta-analysis. Nutr Metab Cardiovasc Dis 2015;25:816-831.
  • De Marchi S, Chiarioni G, Prior M, Arosio E. Young adults with coeliac disease may be at increased risk of early atherosclerosis. Aliment Pharmacol Ther 2013;38:162–169.
  • Bahloul M, Chaari A, Khlaf-Bouaziz N, Kallel H, Chaari L, Ben Hamida C, et al. Celiac disease, cerebral venous thrombosis and protein S deficiency, a fortuitous association? J Mal Vasc 2005;30:228–230.
  • Boucelma M, Saadi M, Boukrara H, Bensalah D, Hakem D, Berrah A. Association of celiac disease and cerebral venous thrombosis: report of two cases. J Mal Vasc 2013;38:47–51.
  • El Moutawakil B, Chourkani N, Sibai M, Moutaouakil F, Rafai M, Bourezgui M, et al. Celiac disease and ischemic stroke. Rev Neurol (Paris) 2009;165:962–966.
  • Not T, Faleschini E, Tommasini A, Repetto A, Pasotti M, Baldas V, et al. Celiac disease in patients with sporadic and inherited cardiomyopathies and in their relatives. Eur Heart J 2003;24:1455–1461.
  • Vizzardi E, Lanzarotto F, Carabellese N, Mora A, Bertolazzi S, Benini F, et al. Lack of association of coeliac disease with idiopathic and ischaemic dilated cardiomyopathies. Scand J Clin Lab Invest 2008;68:692–695.
  • De Bem RS, Da Ro Sa Utiyama SR, Nisihara RM, Fortunato JA, Tondo JA, Carmes ER, et al. Celiac disease prevalence in Brazilian dilated cardiomyopathy patients. Dig Dis Sci 2006 May;51:1016–1019.
  • Frustaci A, Cuoco L, Chimenti C, Pieroni M, Fioravanti G, Gentiloni N, et al. Celiac disease associated with autoimmune myocarditis. Circulation 2002;105:2611-2618.
  • Elnour S, Hashim M, Ibrahim H. Dilated cardiomyopathy associated with celiac disease: A case report. Clin Case Rep 2021;9:e04990.
  • Emilsson L, Smith JG, West J, Melander O, Ludvigsson JF. Increased risk of atrial fibrillation in patients with coeliac disease: a nationwide cohort study. Eur Heart J 2011;32(19):2430–2437.
  • Mah MW, Priel IE, Humen DP, Brown NE, Sproule BJ. Idiopathic pulmonary hemosiderosis, complete heart block and celiac disease. Can J Cardiol 1989;5:191–194.
  • Cottin V, Clerici G, Fabien N, Rousset H, Cordier JF. Celiac disease revealed by diffuse alveolar hemorrhage and heart block. Respir Med Extra 2006;2:89–91.
  • Callejas Rubio JL, Ortego N, Díez-Ruiz A, Guilarte J, de la Higuera-Torres J. Celiac disease presenting as chronic anemia associated with heart block. Am J Gastroenterol 1998;93:1391–1392.
  • Ouali S, Chabrak S, Larbi N, Kafsi N. Dilated cardiomyopathy and atrio-ventricular block in coeliac disease. Two case reports [article in French]. Arch Mal Coeur Vaiss 2006;99:1252–1255.
  • Samy L, Barkun A, Huynh T. Cardiac syncope in a woman with undiagnosed celiac disease. Can Med Assoc J 2017;189:E365–E367.
  • Mannarino S, Santacesaria S, Raso I, Fini G, Pozzi E, Cocuccio C, et al. Atrioventricular block in celiac disease: an unusual clinical presentation in a child: a case-based review. Children 2022;9:1627.
  • Ju YT, Wei YJ, Hsieh ML, Wang JN, Wu JM. Transient congenital complete heart block: a case report. Children (Basel) 2021;8:790.
  • Kitazawa T, Ida M, Kawaguchi M. A case of advanced atrioventricular block after gynecological surgery. JA Clin Rep 2020;6:81.
  • Views: 401
    HTML downloads: 61
    PDF downloads: 310


    Published: 2023-08-09
    Issue: 2023: Vol 10 No 9 (view)


    How to cite:
    1.
    Maadarani O, Bigdelu L, Bitar Z, Alhabibi M, Kabbara H. Spontaneous recovery of isolated advanced heart block in patient with celiac disease by starting a strict gluten free diet: a case report and review of the literature. EJCRIM 2023;10 doi:10.12890/2023_004012.

    Most read articles by the same author(s)

    1 2 > >>