Celiac Disease: Intestinal, Heart and Skin Interconnections

The first description of celiac disease associated with dilated cardiomyopathy and pellagra in the same person, brings multiple interesting aspects to discuss. Celiac disease is prevalent in cardiac failure and vice versa, multiple cardiac manifestations exist in celiac disease. Pathophysiologically, autoimmune, nutritional, infectious and thrombophilic pathways can be involved. In some cases the cardiomyopathy respond to gluten free diet. Multiple cutaneous manifestations, including pellagra like rash, were described in CD. Autoimmune mechanisms and much more, (e.g. nutrient deficiencies) might aggravate the skin manifestation. The present editorial highlights the cardiac-cutaneous-intestinal cross talks in celiac disease in order to increase the awareness of the physician community to speed up celiac disease diagnosis in those extraintestinal manifestations.