Haemorrhage and intestinal lymphoma

Abstract

Background: The prevalence of coeliac disease is around 1% in general population but this is often unrecognised. The classical presentation of adult coeliac disease is characterized by diarrhoea and malabsorption syndrome, but atypical presentations are probably more common and are characterized by iron deficiency anaemia, weight loss, fatigue, infertility, arthralgia, peripheral neuropathy and osteoporosis. Unusual are the coagulation disorders (prevalence 20%) and these are due to vitamin K malabsorption (prolonged prothrombin time).
Clinical case: A 64-year-old man was admitted to our Department for an extensive spontaneous haematoma of the right leg. He had a history of a small bowel resection for T-cell lymphoma, with a negative follow-up and he didn’t report any personal or familiar history of bleeding. Laboratory tests showed markedly prolonged prothrombin (PT) and partial-thromboplastin time (PTT), corrected by mixing studies, and whereas platelet count and liver tests was normal. A single dose (10 mg) of intravenous vitamin K normalized the PT. Several days before the patient had been exposed to a superwarfarin pesticide, but diagnostic tests for brodifacoum, bromadiolone or difenacoum were negative. Diagnosis of multiple vitamin K-dependent coagulationfactor deficiencies (II, VII, IX, X) due to intestinal malabsorption was made and coeliac disease was detected. Therefore the previous lymphoma diagnosis might be closely related to coeliac disease.
Conclusions: A gluten free diet improves quality of life and restores normal nutritional and biochemical status and protects against these complications.

Downloads

Download data is not yet available.
Published
2013-04-30
Section
Case Reports
Keywords:
T-cell lymphoma, PT, aPTT, Vitamin K-dependent coagulation-factor deficiencies, Coeliac disease.
Statistics
Abstract views: 438

PDF: 373
Share it

PlumX Metrics

PlumX Metrics provide insights into the ways people interact with individual pieces of research output (articles, conference proceedings, book chapters, and many more) in the online environment. Examples include, when research is mentioned in the news or is tweeted about. Collectively known as PlumX Metrics, these metrics are divided into five categories to help make sense of the huge amounts of data involved and to enable analysis by comparing like with like.

How to Cite
Pizzini, A. M., Pilia, A., Silingardi, M., Iori, I., & Gelli, M. C. (2013). Haemorrhage and intestinal lymphoma. Italian Journal of Medicine, 4(1), 32-36. https://doi.org/10.4081/itjm.2010.32

Most read articles by the same author(s)