Review for 10.1186/s12876-020-01483-w (2020)

Reviewer’ s report
Title: Concurrent cerebral arterial and venous sinus thrombosis revealing celiac disease - A case
report and literature review
Version: 0Date: 07 Sep 2020
Reviewer: Pablo Guisado-Vasco
Reviewer's report:
Dear Dr Dalia Alhosain,I have read your interesting manuscript entitled, 'Concurrent cerebral arterial and venous sinus
thrombosis revealing celiac disease - a case report and review of the literature' (ID: BMGE-D-20-001020).
It is a case report of a 40-years-old age woman who was admitted to the hospital due to left side
cerebral infarction and sinus venous thrombosis. She also has an underlying, non-diagnosis, celiacdisease.
I have some comments about the current format of the manuscript.1.- Some confusion might be about the format of the manuscript. It was submitted as a case report.
However, the introduction is quite long and general -just focused on celiac disease, and explaininggeneral aspects of the disease, which physicians should be already aware.2.- The discussion is developed around some references and cases of a priori similar scope. A table
summarizing these theoretical common aspects might help to understand the text.
3.- The case has some drawbacks: there is not a clear explanation about the association of celiacdisease and arterial and venous thrombosis in the current case. The plausible mechanisms are notpresent in the description - thrombocytosis is a reactive process due to iron deficiency, or thevitamin K deficiency is frequent in the clinical practice and no thrombosis phenomena are notseen.4.- The antibodies PT/PS were not measured in the description of the case. However, it isexplained as a potential cause of thrombosis in those patients affected by celiac disease. Thisshould be mentioned as a limitation of the case report.5.- An alternative explanation should be considered - especially taking into account the origin ofthe patient. Behçet disease is described to be linked to celiac disease. This point should beincluded in the discussion.
Reference. Koçak E, Akbal E, Beyazit Y, Ergül B, Karataş A et al. Celiac disease prevalence in a
large series of patients with Behçet disease. Int J Rheum Dis 2018; 21(12):2146-2150.
Sincerely,
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Is the study design appropriate to answer the research question (including the use of appropriate
controls), and are the conclusions supported by the evidence presented?
YesAre the methods sufficiently described to allow the study to be repeated?NoIs the use of statistics and treatment of uncertainties appropriate?NoIs the presentation of the work clear?YesAre the images in this manuscript (including electrophoretic gels and blots) free from apparent
manipulation?
Yes