scholarly journals Review: dermatitis herpetiformis

2013 ◽  
Vol 88 (4) ◽  
pp. 594-599 ◽  
Author(s):  
Fernanda Berti Rocha Mendes ◽  
Adaucto Hissa-Elian ◽  
Marilda Aparecida Milanez Morgado de Abreu ◽  
Virgínica Scaff Gonçalves
Keyword(s):  
Dermatitis Herpetiformis ◽  
Tissue Transglutaminase ◽  
Strong Association ◽  
Immunoglobulin A ◽  
Dermal Papilla ◽  
Small Intestinal Mucosa ◽  
Adult Celiac Disease ◽  
Gluten Sensitive Enteropathy ◽  
Hla Dr3

Dermatitis herpetiformis (DH) or Duhring-Brocq disease is a chronic bullous disease characterized by intense itching and burning sensation in the erythematous papules and urticarial plaques, grouped vesicles with centrifuge growth, and tense blisters. There is an association with the genotypes HLA DR3, HLA DQw2, found in 80-90% of cases. It is an IgA-mediated cutaneous disease, with immunoglobulin A deposits appearing in a granular pattern at the top of the dermal papilla in the sublamina densa area of the basement membrane, which is present both in affected skin and healthy skin. The same protein IgA1 with J chain is found in the small intestinal mucosa in patients with adult celiac disease, suggesting a strong association with DH. Specific antibodies such as antiendomysium, antireticulina, antigliadin and, recently identified, the epidermal and tissue transglutaminase subtypes, as well as increased zonulin production, are common to both conditions, along with gluten-sensitive enteropathy and DH. Autoimmune diseases present higher levels of prevalence, such as thyroid (5-11%), pernicious anemia (1-3%), type 1 diabetes (1-2%) and collagen tissue disease. The chosen treatment is dapsone and a gluten-free diet.

scholarly journals Celiac-Related Autoantibodies and IL-17A in Bulgarian Patients with Dermatitis Herpetiformis: A Cross-Sectional Study

Medicina ◽  
2019 ◽  
Vol 55 (5) ◽  
pp. 136
Author(s):  
Tsvetelina Velikova ◽  
Martin Shahid ◽  
Ekaterina Ivanova-Todorova ◽  
Kossara Drenovska ◽  
Kalina Tumangelova-Yuzeir ◽  
...  
Keyword(s):  
Dermatitis Herpetiformis ◽  
Tissue Transglutaminase ◽  
Serum Levels ◽  
Cross Sectional Study ◽  
Serum Samples ◽  
Cross Sectional ◽  
Gastrointestinal Complications ◽  
Gluten Sensitive Enteropathy ◽  
Diagnostic Sensitivity And Specificity ◽  
Average Serum

Background and objectives: Dermatitis herpetiformis (DH) is a blistering dermatosis, which shares common immunologic features with celiac disease (CD). The aim of the present study was to explore the performance of a panel of CD-related antibodies and IL-17A in Bulgarian patients with DH. Materials and Methods: Serum samples from 26 DH patients at mean age 53 ± 15 years and 20 healthy controls were assessed for anti-tissue transglutaminase (anti-tTG), anti-deamidated gliadin peptides (anti-DGP), anti-actin antibodies (AAA), and IL-17A by enzyme linked immuno-sorbent assay (ELISA), as well as anti-tTG, anti-gliadin (AGA), and anti-Saccharomyces cerevisiae antibodies (ASCA) using immunoblot. Results: The average serum levels of anti-tTG, anti-DGP, AGA, AAA, and the cytokine IL-17A were at significantly higher levels in patients with DH compared to the average levels in healthy persons which stayed below the cut-off value (p < 0.05). Anti-DGP and anti-tTG antibodies showed the highest diagnostic sensitivity and specificity, as well as acceptable positive and negative predictive value. None of the healthy individuals was found positive for the tested antibodies, as well as for ASCA within the DH group. All tests showed good to excellent correlations (r = 0.5 ÷ 0.9, p < 0.01). Conclusions: Although the diagnosis of DH relies on skin biopsy for histology and DIF, serologic testing of a panel of celiac-related antibodies could be employed with advantages in the diagnosing process of DH patients. Furthermore, DH patients who are positive for the investigated serologic parameters could have routine monitoring for gastrointestinal complications typical for the gluten-sensitive enteropathy.

scholarly journals Biopsy-Defined Adult Celiac Disease in Asian-Canadians

2003 ◽  
Vol 17 (7) ◽  
pp. 433-436 ◽  
Author(s):  
Hugh James Freeman
Keyword(s):  
Diabetes Mellitus ◽  
Celiac Disease ◽  
North America ◽  
Dermatitis Herpetiformis ◽  
Tissue Transglutaminase ◽  
Chinese Patient ◽  
Asian Populations ◽  
Adult Celiac Disease ◽  
Mucosal Changes ◽  
First Time

Celiac disease is thought to be a genetically based disorder reported mainly from European countries as well as countries to which Europeans have emigrated, including North America. This report documents a clinical experience of biopsy-defined celiac disease in 14 Asians diagnosed since 1988 in a single Canadian teaching hospital. Eleven were Indo-Canadians, including 10 of Punjabi descent. Other ethnic groups were also represented, including two Japanese and one Chinese patient. Abdominal pain was the most frequent presenting symptom. Anemia, particularly associated with a deficiency of iron was common, along with diarrhea and weight loss. Endoscopic studies documented lymphocytic gastric and colonic mucosal changes in over one-third of the cases while antibodies for tissue transglutaminase were positive in all patients tested. Dermatitis herpetiformis, diabetes mellitus and autoimmune liver disease were also documented. These findings indicate for the first time that adult celiac disease occurs in Asian populations living in North America, particularly in those of Punjabi descent.

scholarly journals High Prevalence of Celiac Disease in Patients with Type 1 Diabetes Detected by Antibodies to Endomysium and Tissue Transglutaminase

2001 ◽  
Vol 15 (5) ◽  
pp. 297-301 ◽  
Author(s):  
PM Gillett ◽  
HR Gillett ◽  
DM Israel ◽  
DL Metzger ◽  
L Stewart ◽  
...  
Keyword(s):  
British Columbia ◽  
Type 1 Diabetes ◽  
Celiac Disease ◽  
Growth Parameters ◽  
Morphological Changes ◽  
Tissue Transglutaminase ◽  
Immunoglobulin A ◽  
Gluten Free Diet ◽  
Gluten Free

OBJECTIVE: To establish the prevalence of celiac disease (CD) in children with type 1 diabetes in British Columbia.PATIENTS AND METHODS: Two hundred thirty-three children with type 1 diabetes were prospectively screened for CD using blind testing with the current 'gold standard', immunoglobulin A endomysium antibody (EmA), and the novel immunoglobulin A tissue transglutaminase (tTG) antibody. Those children with positive results were offered small bowel biopsy; a gluten-free diet was recommended if CD was confirmed.RESULTS: Nineteen children were positive for EmA and had an elevated tTG level. One patient from this group was already known to have CD, and the other 18 patients consented to biopsy. One biopsy was normal, three biopsies demonstrated elevated intraepithelial lymphocyte counts with normal morphology and 14 biopsies had morphological changes consistent with CD. Growth parameters were normal in all patients, and nine of 19 children who were positive for EmA were asymptomatic. Seven patients had mild elevation of tTG levels alone. Two children from this latter group had normal biopsies, and five declined biopsy.CONCLUSIONS: At least 14 new cases of CD were detected in addition to four known cases, yielding an overall biopsy-confirmed prevalence of CD of 7.7% (18 of 233). The present study confirms that CD is as prevalent in the pediatric type 1 diabetic population in British Columbia as it is in Europe. Serological screening of these children is important because many children have no symptoms or signs suggestive of CD. This study suggests that tTG serology may also be useful in monitoring response and compliance with a gluten-free diet.

scholarly journals Description of a clinical case of combination of celiac disease and ichthyosis in a girl

2021 ◽  
pp. 134-139
Author(s):  
A. T. Kamilova ◽  
S. I. Geller ◽  
X. T. Ubaykhodjaeva
Keyword(s):  
Celiac Disease ◽  
Clinical Case ◽  
Tissue Transglutaminase ◽  
Gastrointestinal Symptoms ◽  
Active Phase ◽  
Final Diagnosis ◽  
Nutritional Deficiencies ◽  
Small Intestinal Mucosa ◽  
Gluten Sensitive Enteropathy ◽  
Severe Degree

Abstract Introduction. Celiac disease, or gluten-sensitive enteropathy, can be defined as a persistent intolerance of wheat gliadins and other cereal prolamines in the small intestinal mucosa of genetically susceptible individuals. The clinical picture of the disease can often be misleading because it varies greatly from patient to patient, resulting in delayed diagnosis.To analyze the clinical case of a child with celiac disease and acquired ichthyosis.Results. The disease, until a final diagnosis was established, had a severe course due to gastrointestinal and dermatological disorders. From the age of 1.5 years, the child had frequent diarrhea, bloating, which is why she was repeatedly hospitalized in the hospital at the place of residence. However, there was no effect from the ongoing therapeutic measures, and other symptoms such as vomiting, peripheral edema, deficiency of height and weight, and severe peeling of the skin joined in. The diagnosis was finally confirmed at the age of 2.5 years after the test for antibodies to tissue transglutaminase IgA (fifty-fold excess relative to the norm). A genetic study revealed alleles of genes responsible for predisposition to celiac disease. The results of a biopsy of the mucous membrane of the duodenum had signs of atrophy, lymphoid infiltration, corresponding to a lesion of the small intestine according to the classification Marsh III. Microscopic examination of the skin – hyperkeratosis with a decrease in the granular layer. On the basis of the obtained data, the diagnosis was made: Celiac disease, active phase, severe course, complicated by proteinenergy insufficiency severe degree, exudative enteropathy syndrome, 2 degree anemia, concomitant diagnosis: acquired ichthyosis. The girl was prescribed a gluten-free diet, and symptomatic drug therapy was carried out. In dynamics, the condition has improved. After 6 months, at the second visit, gastrointestinal and skin symptoms were absent, physical development was age-appropriate.Conclusions. The classic form of celiac disease usually manifests itself with several major symptoms, such as diarrhea, abdominal pain, weight loss, and nutritional deficiencies. In this article we wanted to talk about a rare combination of celiac disease with ichthyosis, therefore, practitioners should be wary of a combination of skin and gastrointestinal symptoms.

scholarly journals Intestinal TG3- and TG2-Specific Plasma Cell Responses in Dermatitis Herpetiformis Patients Undergoing a Gluten Challenge

Nutrients ◽  
2020 ◽  
Vol 12 (2) ◽  
pp. 467
Author(s):  
Hanna Sankari ◽  
Minna Hietikko ◽  
Kalle Kurppa ◽  
Katri Kaukinen ◽  
Eriika Mansikka ◽  
...  
Keyword(s):  
Coeliac Disease ◽  
Plasma Cell ◽  
Plasma Cells ◽  
Dermatitis Herpetiformis ◽  
Immunoglobulin A ◽  
Small Intestinal Mucosa ◽  
Gluten Free ◽  
Cell Responses ◽  
Small Intestinal ◽  
Circulating Autoantibodies

Dermatitis herpetiformis (DH), a cutaneous manifestation of coeliac disease, is characterized by transglutaminase (TG) 3-targeted dermal immunoglobulin A (IgA) deposits. The treatment for DH is the same as for coeliac disease, namely a life-long gluten-free diet. DH patients typically have gluten-dependent circulating autoantibodies targeting TG3 and TG2, and plasma cells secreting such autoantibodies have been detected in the small intestinal mucosa. This study investigates the gluten-responsiveness of intestinal TG3 and TG2 antibody-secreting plasma cells in 16 treated DH patients undergoing a gluten challenge. The frequency of both plasma cell populations increased significantly during the challenge, and their frequency correlated with the corresponding serum autoantibody levels at post-challenge. TG3-specific plasma cells were absent in all 18 untreated coeliac disease patients and seven non-coeliac control subjects on gluten-containing diets. These findings indicate that, in DH, both intestinal TG3- and TG2-antibody secreting plasma cells are gluten-dependent, and that TG3-antibody secreting plasma cells are DH-specific.

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