DOI: 10.12890/2024_004763

Severe coagulopathy and intra-alveolar haemorrhage due to fat malabsorption in celiac disease

Authors

  • Ori Lencovsky Internal Medicine Ward A, Samson Assuta Ashdod University Hospital, Ashdod, Israel; Nephrology and Hypertension Department, Samson Assuta Ashdod University Hospital, Ashdod, Israel
  • Daphna Katz-Talmor Internal Medicine Ward A, Samson Assuta Ashdod University Hospital, Ashdod, Israel
  • Benjamin Aronoff Nephrology and Hypertension Department, Samson Assuta Ashdod University Hospital, Ashdod, Israel; Department of Internal Medicine, Hackensack University Medical Center, Hackensack Meridian School of Medicine, Nutley, USA

ori.lencovsky@gmail.com

Keywords

Celiac disease, coagulopathy, fat malabsorption, vitamin K deficiency, intra-alveolar haemorrhage

Abstract

Celiac disease, a prevalent autoimmune disorder, can present atypically with fat malabsorption and coagulopathy due to vitamin K malabsorption.
A 64-year-old male presented with haemoptysis and severe anaemia (Hb 6 g/dl). Despite normal previous coagulation tests, admission laboratory tests revealed an international normalised ratio (INR) of 7.0 and iron deficiency anaemia. Initial blood products and vitamin K treatment corrected the INR temporarily, but the patient’s haemoptysis returned, and his INR values continued to rise. Further investigation revealed celiac disease with fat malabsorption, leading to vitamin K malabsorption and along with a previously prescribed antiplatelet aggregation therapy, this led to diffuse alveolar haemorrhage. A gluten-free diet and vitamin supplementation normalised the patient’s INR and stopped the bleeding.
This case highlights the importance of considering celiac disease in unexplained coagulopathies and the effectiveness of dietary management.

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References

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Published

2024-09-02

Issue

Vol. 11 No. 9 (2024)

Categories

How to Cite

1.
Lencovsky O. Severe coagulopathy and intra-alveolar haemorrhage due to fat malabsorption in celiac disease. EJCRIM [Internet]. 2024 Sep. 2 [cited 2026 Nov. 3];11(9). Available from: https://ejcrim.com/index.php/ejcrim/article/view/4763