Deep Vein Thrombosis Revealing A “Silent” Coeliac Disease

INTRODUCTION: We present a clinical case of a 45-year-old man with recurrent deep vein thrombosis (DVT) and multiple hospital admissions due to severe infectious conditions. A newfound hypoalbuminemia raised the suspicion of a protein-losing condition, with an upper endoscopy revealing lesions at the D2 level compatible with coeliac sprue and HLA typing positive for both DQ-2 and DQ-8. METHODS: A gluten free diet was started and apixaban was suspended. RESULTS: No new complications were reported. DISCUSSION: Multiple mechanisms are believed to be behind the association between DVT and coeliac disease. However, to this date, no consensus exists regarding the ideal duration of anticoagulation. LEARNING POINTS: Coeliac disease should always be considered a systemic disease. Thromboembolism is a possible extraintestinal manifestation of coeliac disease. Coeliac disease should be considered as a possible cause of thromboembolism even in the absence of gastrointestinal symptoms, which it can precede by several years.