Celiac disease and cardiomyopathy in an adolescent with occult cirrhosis

Patients with celiac disease commonly present with gastrointestinal symptoms including abdominal pain, bloating, constipation or diarrhea. Extraintestinal manifestations of this small bowel disease are increasingly recognized, and greater numbers of patients are being diagnosed after presenting solely with nongastrointestinal symptoms. The present report describes a case involving a 16-year-old girl with oligomenorrhea who was found to have celiac disease and liver cirrhosis of unknown etiology. Subsequent evaluation revealed cardiac dysfunction consistent with cirrhotic cardiomyopathy, a rare finding in the paediatric population. This patient's unusual presentation permits an exploration of several conditions uncommonly reported in conjunction with celiac disease.