An Unusual Complication at an Unusual Site: Internal Jugular Vein Thrombosis Revealing Celiac Disease

罕见部位的罕见并发症:颈内静脉血栓形成揭示乳糜泻

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Abstract

Celiac disease is now recognized as a common disorder that can be diagnosed at any age and affects many organ systems. Its clinical expressions can appear as digestive or extra-digestive; among these, thromboembolic events are the focus of our study. We report a case of a 63-year-old woman who presented with left-sided cervical swelling associated with edema of the left upper limb, with generalized weakness and weight loss. The clinical examination revealed a tender cervical mass in the region of the internal jugular vein. Doppler ultrasound demonstrated thrombosis of the left internal jugular vein extending into the subclavian vein, in the absence of classical risk factors for venous thrombosis. Laboratory investigations showed iron deficiency microcytic anemia and a biological malabsorption profile. Celiac disease was suspected and confirmed by positive serology and duodenal biopsies showing villous atrophy (Marsh 3C). The patient was treated with anticoagulation and a strict gluten-free diet, with a favorable clinical evolution. This case highlights celiac disease as a potential underlying cause of unexplained unusual-site venous thrombosis.

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