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Coeliac disease presenting as variceal haemorrhage
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CASE REPORT
A 59 year old woman was referred for investigation of lethargy, ankle oedema, and an elevated alkaline phosphatase. Sixteen years previously her entire jejunum had been resected at another hospital for acute mesenteric vein thrombosis.
On investigation, alkaline phosphatase and prothrombin time were raised, and calcium, haemoglobin, and red cell folate were low. She was heterozygous for the prothrombin 20210A gene mutation and table 1 summarises the results of her thrombophilia screen. Activated protein C resistance, antithrombin activity, anticardiolipin antibodies, haemolysis, and paroxysmal nocturnal haemoglobinuria screen were normal or negative. …