Association of Budd-Chiari syndrome and celiac disease

Background and aims

An association between Budd-Chiari syndrome (BCS) and celiac disease (CD) is uncommon. The aims of our study were to investigate the etiology of BCS and to search for a particular HLA Ag pattern among patients.

Patients and methods

BCS diagnosis was based on Doppler ultrasound and CD diagnosis on duodenal biopsy, transglutaminase (TGAb) and gliadin antibodies (GAb). Patients were screened for prothrombotic disorders and seven had a PCR-SSO test for HLA genotypes. Patients were treated with anticoagulants and gluten-free diet.

Results

Nine patients were included; mean age 27 years (20–42); sex ratio (F/M) 2; mean follow-up duration 31 months (6–54). All patients had endoscopic and histological features of CD. GAb/TGAb were found in 78 % (n = 7). Ag HLA found were HLA DQβ1^*02 (n = 6) and DQβ1^*03 (n = 3). Prothrombotic conditions identified were latent myeloproliferative disorder (n = 1), protein C deficiency (n = 1), probable factor V Leiden (n = 1) and oral contraceptive use (n = 1). No prothrombotic state could be identified in the five other patients.

Conclusion

The BCS–CD association is relatively frequent in our country. Underlying prothrombotic conditions were absent in more than 50 % of cases, suggesting CD plays a role in the occurrence of thrombosis. HLA alleles found are strongly associated with CD, without any particular pattern for the BCS–CD association.