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Editor's quiz: GI snapshot
Acute variceal bleeding in a man with coeliac disease
  1. Crispin Okwiri Musumba1,
  2. Fiona Campbell2,
  3. Sreedhar Subramanian1,
  4. Paul Richardson1,
  5. Howard L Smart1
  1. 1Departments of Gastroenterology and Hepatology, The Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, UK
  2. 2Department of Histopathology, The Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, UK
  1. Correspondence to Dr Howard L Smart, Department of Gastroenterology and Hepatology, The Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool L7 8XP, UK; howard.smart{at}rlbuht.nhs.uk

https://doi.org/10.1136/gutjnl-2012-303032

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    A 49-year-old man presented with a 1-week history of melaena, lethargy and dizziness. He had been diagnosed with coeliac disease (CD) 1 year earlier, following referral for haematology review due to splenomegaly and pancytopenia. Physical examination revealed pallor and splenomegaly. He reported strict adherence with gluten-free diet, and no weight loss. Laboratory tests showed haemoglobin concentration of 6.2 g/dl, platelet count of 63×109/l, urea 9.3 mmol/l, aspartate transaminase 49 μ/l, alanine transaminase 38 μ/l, normal alkaline phosphatase, albumin 34 g/l, IgA anti-tissue transglutaminase antibodies 7.3 μ/ml (normal <7), and normal clotting profile. Chronic liver disease screen was negative, and thrombophilia screen showed slightly elevated IgM anticardiolipin antibodies (aCL). …

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    Footnotes

    • Competing interests None.

    • Patient consent Obtained.

    • Ethics approval This was not a formal study but a report on the clinical management of a patient who presented with acute gastrointestinal bleeding. Formal ethics committee consent was not required, but patient consent was obtained.

    • Provenance and peer review Not commissioned; internally peer reviewed.