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Autoimmunity in dermatitis herpetiformis: Effect of a gluten-free diet

1991; Informa; Volume: 2; Issue: 3 Linguagem: Inglês

10.3109/09546639109092727

1471-1753

Jp McFadden, JN. Leonard, A.V. Powles, L. Fry,

Microscopic Colitis

Of 165 patients with dermatitis herpetiformis OH) assessed for autoimmune status, autoantibodies were present in 101 (61.2%) and autoimmune disease in 20 (12%) on prekntation; a further nine patients (5.5%) had developed autoimmune disease at follow up (mean 8.1 years). Autoimmune status did not correlate with severity of small-bowel enteropathy as assessed by microscopy or by intraepithelial lymphocyte count. There was also no correlation with age, sex, duration of rash before presentation or age at onset of rash. Of 162 patients followed up (mean 8.1 yrs), 156 were on definitive treatment. In all treatment groups there was an overall trend to development of autoimmune disease/autoantibodies in a minority of patients. Autoantibodies/ autoimmune disease developed in subjects initially autoantibody-negative in 5/26 (19%) on a strict gluten-free diet, 5/16 (31%) on drug therapy plus gluten avoidance and 2/19 (11%) on drug therapy alone. Treatment with a gluten-free diet did not result in resolution of autoimmune disease or disappearance of organ-specific antibodies in DH. These results indicate that development of autoimmune disease is independent of both gluten intake and severity of bowel disease, but is more likely to be due to an underlying immunological mechanism which is probably genetically determined.