Why the study?
Cardiac involvement like atrioventricular block in celiac disease has mainly been described in untreated adults, but pediatric presentations are rare.
Does a strict gluten-free diet improve acquired atrioventricular block in a child with celiac disease?
Does a strict gluten-free diet improve acquired atrioventricular block in a child with celiac disease?
A strict gluten-free diet may reverse acquired atrioventricular block in children with celiac disease, suggesting that celiac screening should be considered in pediatric acquired AVB.
AVB-CeD association unproven in children; leaves open need for pediatric-specific studies before any screening changes.
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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Mannarino et al. (2022) studied this question.
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