Gluten enteropathy in patients with dermatitis herpetiformis

Author: A/Prof Amanda Oakley, Dermatologist, Hamilton, New Zealand, 2001.

What is gluten enteropathy?

Gluten enteropathy, or coeliac disease, affects the majority of children and adults with dermatitis herpetiformis. It is characterised by small bowel villous atrophy. This means that instead of being highly convoluted, the lining of the intestines is smooth and flattened. The result is poor or very poor absorption of nutrients. The patient may feel well or develop the following symptoms:

Other features of coeliac disease

The range of conditions less commonly induced by gluten also includes:

Patients with coeliac disease sometimes suffer from other autoimmune conditions possibly associated with gluten intolerance. These include insulin-dependent diabetes mellitus, thyroiditis, autoimmune hepatitis, Sjögren's syndrome, Addison's disease, atrophic gastritis, alopecia areata, vitiligo, and urticaria.

They may also be affected by conditions that are not related to gluten intolerance. These include IgA deficiency, psoriasis, Down syndrome and primary biliary cirrhosis.

Non-Hodgkin´s lymphoma, affecting the intestines or any part of the body, is a serious complication of gluten enteropathy but is fortunately rare, affecting less than 1% of patients.

For further information about testing and treatment, see DermNet's page on dermatitis herpetiformis

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