Serological screening for coeliac disease in vitiligo and alopecia areata

Volta, Umberto; Bardazzi, Federico; Zauli, Daniela; DeFranceschi, L; Tosti, Antonella; Molinaro, N.; Ghetti, Sabrina; Tetta, Cecilia; Grassi, Alberto; Bianchi, F. B.

doi:10.1111/j.1365-2133.1997.tb03684.x

Cited by 46 publications

(38 citation statements)

References 10 publications

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“…The association of these dermatological conditions with CD is considered coincidental by some authors (19) and with immunological implications by others (71) .…”

Section: Dermatological Disordersmentioning

confidence: 96%

Celiac disease in Brazilian patients: associations, complications and causes of death. Forty years of clinical experience

Kotze

2009

Arq. Gastroenterol.

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-Context -Celiac disease is a multisystem auto-immune disorder and may start at any age in genetically predisposed individuals. Objective -To identify associations, complications, and cause of death in Brazilian patients. Methods -One hundred and fifty-seven patients were studied: 23 adolescents and 134 adults, 79.6% females, 20.4% males, 75.8% at the time of diagnosis and 24.2% on a gluten-free diet, follow-up between 1 and 40 years. The diagnosis of celiac disease was based on histologic findings and the presence of serologic auto-antibodies markers for celiac disease. Specific tests were done according to clinical suspicion of associations. Bone mineral density was determined by dual energy x-rays in 53 patients upon diagnosis. The data regarding associations, complications, and causes of death were obtained by interviews and from the patient's charts. -Results -Associations: atopy (22.3%), depression (17.2%), thyroid disorder (15.9%), dermatitis herpetiformis (11.5%), diabetes mellitus types 1 and 2 (4.5%) and tumors (4.5%). Complications -Anemia and osteopenia/osteoporosis in all groups; increased number of spontaneous abortion. Four patients (4.5%) died (one from lymphoma, one with diabetes type 1, one from acute meningitis and one due to suicide). Conclusions -This experience is similar to those described in the world literature. Celiac disease presents the same characteristics independently of the geographic region. We recommend periodic evaluations, from childhood, independent of the duration of the diet. The key is to establish an interval between evaluations. HEADINGS -Celiac disease. Gluten. Lymphoma, non-Hodgkin.

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“…The association of these dermatological conditions with CD is considered coincidental by some authors (19) and with immunological implications by others (71) .…”

Section: Dermatological Disordersmentioning

confidence: 96%

Celiac disease in Brazilian patients: associations, complications and causes of death. Forty years of clinical experience

Kotze

2009

Arq. Gastroenterol.

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“…The withdrawal of gluten reverses not only the intestinal, but also the skin lesions in most dermatitis herpetiformis patients. Many other pathological conditions, such as autoimmune disorders (insulin-dependent diabetes mellitus type 1, thyroid disorders, autoimmune hepatitis, primary biliary cirrhosis, primary sclerosing cholangitis, alopecia, vitiligo, Addison's disease, Sjögren's syndrome, IgA nephropathy and IgA deficiency), [55][56][57][58][59][60][61][62][63][64][65] idiopathic disorders (primitive dilated cardiomyopathy, atopy and inflammatory bowel disease) [66][67][68] and chromosome disorders (Down, Turner and Williams syndromes), [69][70][71] display a strong association with CD. The importance of diagnosing the subclinical form of CD associated with these disorders is twofold because a gluten-free diet not only prevents the clinical manifestations and complications of CD but also sometimes improves clinical symptoms of the associated disorders (Table 3).…”

Section: Introductionmentioning

confidence: 99%

Celiac disease: diagnostic criteria in progress

2011

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Until a few years ago, celiac disease (CD) was thought to be a rare food intolerance that was confined to childhood and characterized by severe malabsorption and flat intestinal mucosa. Currently, CD is regarded as an autoimmune disorder that is common in the general population (affecting 1 in 100 individuals), with possible onset at any age and with many possible presentations. The identification of CD is challenging because it can begin not only with diarrhea and weight loss but also with atypical gastrointestinal (constipation and recurrent abdominal pain) and extra-intestinal symptoms (anemia, raised transaminases, osteoporosis, recurrent miscarriages, aphthous stomatitis and associated autoimmune disorders), or it could be completely symptomless. Over the last 20 years, the diagnostic accuracy of serology for CD has progressively increased with the development of highly reliable tests, such as the detection of IgA tissue transglutaminase and antiendomysial and IgG antideamidated gliadin peptide antibodies. The routine use of antibody markers has allowed researchers to discover a very high number of 'borderline' cases, characterized by positive serology and mild intestinal lesions or normal small intestine architecture, which can be classified as potential CD. Therefore, it is evident that the 'old celiac disease' with flat mucosa is only a part of the spectrum of CD. It is possible that serology could identify CD in its early stages, before the appearance of severe intestinal damage. In cases with a positive serology but with mild or absent intestinal lesions, the detection of HLA-DQ2 and HLA-DQ8 can help reinforce or exclude the diagnosis of gluten sensitivity.

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“…Volta et al (4) found no seropositive cases among their 198 patients with vitiligo. In another study performed in patients with type 1 diabetes mellitus, vitiligo was more frequent in those with CD (30% vs. 3%) (6).…”

Section: To the Editormentioning

confidence: 94%