A case report published in BMJ Case Reports (March 14, 2016; Article ID bcr2015213301) described a 57-year-old man with severe iron-deficiency anemia and cardiomyopathy. Cardiac evaluation revealed marked dilation of the left ventricle and a severely reduced ejection fraction of 15%. He was initially treated with standard medical therapy, including high-dose diuretics, ACE inhibitors, and beta-blockers.
Further investigation uncovered previously undiagnosed celiac disease. After the patient began a gluten-free diet, his cardiac function improved substantially. His ejection fraction increased to 70%, and he was eventually able to discontinue all cardiac medications.
The authors suggested that celiac disease may represent an underrecognized and potentially reversible cause of cardiomyopathy in some patients, particularly when associated with significant nutrient malabsorption.
