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Gluten enteropathy in patients with dermatitis herpetiformis
Author: A/Prof Amanda Oakley, Dermatologist, Hamilton, New Zealand. 2001.
What is gluten enteropathy?
Gluten enteropathy, commonly called 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:
Abdominal discomfort and bloating (75%)
Weight loss (30%)
Constipation (30%) or diarrhoea (50%)
Pale stools that float on the surface of the toilet pan
Bone fractures due to osteoporosis.
Other features of gluten enteropathy
The range of conditions less commonly induced by gluten also includes:
Neurological problems including ataxia (loss of balance), polyneuropathy, epilepsy
Heart problems including pericarditis and cardiomyopathy
Patients with gluten enteropathy or coeliac disease sometimes suffer from other autoimmune conditions possibly associated with gluten intolerance. These include insulin-dependent diabetes mellitus, thyroiditis, autoimmune hepatitis, Sjögren syndrome, Addison disease, atrophic gastritis, alopecia areata, vitiligo, and urticaria.