A Rare Association of Celiac Disease with Gastric Antral Vascular Ectasia and Budd-Chiari Syndrome
Priyanka Udawat, Dr Anu Bhandari, Dr. Kusum Devpura, Dr A.J. Mehta
Citation Information :
Udawat P, Bhandari DA, Devpura DK, Mehta DA. A Rare Association of Celiac Disease with Gastric Antral Vascular Ectasia and Budd-Chiari Syndrome. Ann Pediatr Gastroenterol Hepatol 2019; 1 (3):36-40.
We are reporting a case of 11 year girl with Budd-Chiari syndrome (BCS) & gastric antral vascular ectasia (GAVE) occurring in a patient with celiac disease, who presented with symptoms of abdominal distension, easy fatigability, pallor for one year and shortness of breath for 2 days prior to admission. Initial assessment revealed the presence of severe pallor and splenomegaly. Blood investigation showed pancytopenia and USG abdomen with doppler was suggestive of portal hypertension. On routine endoscopy, she was found to have antral nodularity, GAVE, changes of portal hypertensive gastropathy and duodenal nodularity in first and second part of duodenum. Suspecting celiac disease, she was investigated further. Her serum IgA antitissue transglutaminase antibody titers were elevated (> 100 units/mL) and duodenal biopsy was suggestive of celiac disease. She showed functional deficiency of protein C and protein S. There was narrowing of inferior vena cava as the possible cause of portal hypertension. Patient was kept on gluten free diet (GFD) and GAVE completely resolved in 6 months. Literature on BCS with celiac disease is present but associated GAVE is interestingly rare finding. We are reporting first case of GAVE with celiac disease in India.
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