Cardiac syncope in a woman with undiagnosed celiac disease

Samy, Laïla; Barkun, Alan N.; Huynh, Thao

doi:10.1503/cmaj.151043

Cited by 6 publications

(5 citation statements)

References 11 publications

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“…(7) Presentation patterns with atrioventricular block and syncope, suggesting that the myocardium is affected in CDs, have also been demonstrated in isolated cases. (9,10) In the literature, QTc interval prolongation was observed in one-third of untreated adult CDs, whereas this rate was 3% in patients on a gluten free diet. (11) In the literature there are a lot of studies investigating the relationship of the diet and the ventricular repolarization parameters.…”

Section: Discussionmentioning

confidence: 99%

Çölyak Hastalarında Elektrokardiyografik Değerlendirmenin Önemi

Taşkın

Orgun

2023

Osmangazi̇ Journal of Medicine

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At the present study, study we aimed to analyze the risk factors for cardiac arrhythmias related disease factors by evaluating some ventricular repolarization parameters in the electrocardiographic (ECG) evaluation of CD. The study was conducted retrospectively from the files of the patients. The ECG evaluation of 63 patients aged 5-18 years diagnosis with CD and 63 healthy control group in Adana City Training and Research Hospital, between 01.2018-11.2022. Patients who were taking any drugs, who had a chronic disease and/or abnormal tests (vitamin B12, folate, tissue transglutaminase, anti-endomysium antibody titers) were excluded from the study. The ventricular repolarization parameters (QT interval, QTc interval, QT dispersion, QTc dispersion, Tp-e interval, Tp-e/QT, Tp-e/QTc) analyzed on ECG and compared both groups. The measured ventricular repolarization parameters of the patients and control groups were not statistically different. From the ECG data, it was found that the QTc min value was higher in patients diagnosed before 5 years old than the patients diagnosed after 8 years old. While the QTc dispersion was higher in patients diagnosed after 8 years old than the patients with an age at diagnosed before 5 years old. It was found that the values of QT min, QT max, and QT in the ECG were influenced by the duration of the disease and significantly high related with the disease duration (more than 5 years). We found that QTc dispersion was higher in patients with a later diagnosis. This suggests that cardiac involvement is also increased in patients with a late diagnosis.

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Section: Discussionmentioning

confidence: 99%

Çölyak Hastalarında Elektrokardiyografik Değerlendirmenin Önemi

Taşkın

Orgun

2023

Osmangazi̇ Journal of Medicine

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“…Classically, CeD is diagnosed among children presenting gastrointestinal manifestations of it, but a more complex multisystemic involvement can be observed with neurological, psychiatric, dermatologic, ocular, musculoskeletal, endocrine, pulmonary, and reproductive manifestations [ 15 ]. Moreover, in untreated CeD patients, a damaged cardiovascular system can be observed such as cardiomyopathy [ 16 ], myocarditis, pericardial effusion, arrhythmias, and premature atherosclerosis [ 17 ]. In some cases, young adults with auto-immune myocarditis, which is characterized by lymphocytic infiltrates, carry silent CeD that is usually not associated with any chronic gastrointestinal symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, a recent meta-analysis reported that adult patients having a later diagnosis of CeD, had a 38% increased risk of developing atrial fibrillation [ 10 ]. Rare cases of AVB with CeD in adult patients with an associated extra-cardiac manifestation have been reported [ 19 , 20 , 21 , 22 , 23 ] apart from a case of isolated AVB that was described in a 42-year-old white woman [ 17 ] presenting with syncope secondary to a high-grade heart block. In this patient, a CeD diagnosis was posed, and her conduction abnormalities promptly improved five months after a gluten-free diet introduction [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

Atrioventricular Block in Celiac Disease: An Unusual Clinical Presentation in a Child. A Case-Based Review

et al. 2022

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Congenital or acquired atrioventricular block (AVB) is a rare disorder in the pediatric population, while celiac disease (CeD) is a common multisystemic autoimmune disorder that is characterized by intestinal manifestations as they are the typical clinical presentation. Sometimes CeD presents more complex multisystemic involvement which includes the heart. Cardiac involvement, such as dilated cardiomyopathy, myocarditis or conduction disease, have been mainly described in untreated adult patients with or without gastro-intestinal symptoms; rare cases of AVB and CeD have been also reported, particularly in association with extra-cardiac manifestations. We describe a case of a progressive acquired AVB block in a 4-year-old child, in which CeD was later diagnosed. A rapid and significantly improvement of the AVB grade has been obtained after the child started a strict gluten-free diet, and so we suggest including diagnostic exams for CeD in all of the children with acquired AVB.

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“…In contrast, in two case reports, both patients had concomitant dilated cardiomyopathy with celiac disease and heart block [23,24] . One case report in the literature demonstrated an isolated atrioventricular block in a 42-year-old female who presented with syncope and high-grade atrioventricular block, and her workup revealed undiagnosed celiac disease and iron deficiency anaemia with no other concomitant pathology and her conduction abnormality improved five months after a gluten-free diet introduction [25] . A paediatric case of 4-year-old male with acquired progressive atrioventricular block who was diagnosed with celiac disease demonstrated a significant improvement of his conduction abnormality after a strict gluten-free diet.…”

Section: Case Descriptionmentioning

confidence: 99%

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

Maadarani,

Bigdelu,

Bitar

et al. 2023

European Journal of Case Reports in Internal Medicine

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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.

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Cardiac syncope in a woman with undiagnosed celiac disease

Cited by 6 publications

References 11 publications

Çölyak Hastalarında Elektrokardiyografik Değerlendirmenin Önemi

Çölyak Hastalarında Elektrokardiyografik Değerlendirmenin Önemi

Atrioventricular Block in Celiac Disease: An Unusual Clinical Presentation in a Child. A Case-Based Review

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

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