title: Cardiomyopathy responsive to gluten withdrawal in a patient with coeliac disease.
abstract: A 57-year-old man with iron deficiency anaemia developed general malaise, exertional dyspnoea and features of cardiac failure out of proportion to his anaemia (haemoglobin 120 g/L). Investigations showed a severely dilated left ventricle with an ejection fraction of 15%, due to dilated cardiomyopathy. He was treated with high-dose diuretics, ACE inhibitors and β-blocker therapy. Subsequent investigation into his iron deficiency anaemia revealed a new diagnosis of coeliac disease. After starting a gluten-free diet, his cardiac function improved markedly, with ejection fraction reaching 70%, allowing his cardiac medications to be withdrawn. This case suggests a link between coeliac disease and cardiomyopathy.
authors.affiliation: Wexham Park Hospital, Slough, UK.
authors.forename: Samuel
authors.initials: S
authors.lastname: McGrath
authors.affiliation: Wycombe Hospital, High Wycombe, UK.
authors.forename: Angharad
authors.initials: A
authors.lastname: Thomas
authors.affiliation: Stoke Mandeville Hospital, Aylesbury, UK.
authors.forename: David Angelo
authors.initials: DA
authors.lastname: Gorard
mesh_terms: D018798:Anemia, Iron-Deficiency / Q000209:etiology; D002311:Cardiomyopathy, Dilated / Q000175:diagnosis / Q000209:etiology*; D002446:Celiac Disease / Q000150:complications / Q000175:diagnosis*; D055050:Diet, Gluten-Free; D004452:Echocardiography; D006333:Heart Failure / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged