Key result
Despite adherence to a gluten-free diet, ventricular dysfunction persisted in a 19-year-old man with dilated cardiomyopathy and coeliac disease, necessitating referral for cardiac transplantation.
Case Report (n=1)
Coeliac disease may present initially as dilated cardiomyopathy, though the causal relationship remains unclear and ventricular dysfunction may persist despite a gluten-free diet.
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Screening for coeliac disease merits consideration in unexplained dilated cardiomyopathy; this case leaves open reversibility with gluten-free diet.
Global ventricular impairment is a frequent presentation in clinical practice, but dissection of causative mechanisms from clinical associations is challenging. We present the case of a 19-year-old man who presented with dilated cardiomyopathy as the first presentation of coeliac disease. The manifestation of iron deficiency anaemia prompted gastroenterology input and enabled accurate diagnosis. It is unclear whether coeliac disease was simply coexistent or directly implicated in pathophysiology. Mechanisms may relate to nutritional deficiencies or autoimmune myocarditis arising from cross-reactivity. We advocate early multidisciplinary involvement in such contexts to aid with management strategy. Despite adherence to a gluten-free diet, ventricular dysfunction persisted and he has been referred to a cardiac transplant centre.
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Patel et al. (2018) conducted a case report in Dilated cardiomyopathy and coeliac disease (n=1). Gluten-free diet was evaluated on Ventricular dysfunction. Despite adherence to a gluten-free diet, ventricular dysfunction persisted in a 19-year-old man with dilated cardiomyopathy and coeliac disease, necessitating referral for cardiac transplantation.
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