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:
Tiredness (80%)
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.
Dermatitisherpetiformis
Dermatitis herpetiformis
Dermatitis herpetiformis
Other features of gluten enteropathy
The range of conditions less commonly induced by gluten also includes:
Patients with gluten enteropathy or coeliac disease sometimes suffer from other autoimmune diseases possibly associated with gluten intolerance. These include insulin-dependent diabetes mellitus, thyroiditis, autoimmunehepatitis, Sjögren syndrome, Addison 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 primarybiliarycirrhosis.
Non-Hodgkin 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.