Coeliac disease and alopecia areata in childhood

Fessatou, Smaragdi; Kostaki, Maria; Karpathios, T

doi:10.1046/j.1440-1754.2003.00116.x

Cited by 39 publications

(29 citation statements)

References 30 publications

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“…The response of AA in CD patients to GFD is controversial. Some studies have reported a complete regrowth of scalp and other body hair in CD patients with AA [30,37], while others did not find any response [38,39]. …”

Section: Mucocutaneous Manifestations Of CDmentioning

confidence: 99%

Extraintestinal Manifestations of Celiac Disease

Pinto-Sanchez¹,

Berčík²,

Verdú³

et al. 2015

Dig Dis

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Case finding for celiac disease (CD) is becoming increasingly common practice and is conducted in a wide range of clinical situations ranging from the presence of gastrointestinal symptoms to failure to thrive in children, prolonged fatigue, unexpected weight loss and anemia. Case finding is also performed in associated conditions, such as autoimmune thyroid disease, dermatitis herpetiformis and type 1 diabetes, as well as in patients with irritable bowel syndrome, unexplained neuropsychiatric disorders and first-degree relatives of patients with diagnosed CD. This aggressive active case finding has dramatically changed the clinical characteristics of newly diagnosed patients. For instance, higher numbers of patients who present with extraintestinal symptoms are now being diagnosed with CD. Current recommendations state that due to a high risk for complications if the disease remains undiagnosed, patients with extraintestinal symptoms due to CD require appropriate diagnosis and treatment. Despite criticism regarding the cost-effectiveness of case finding in CD, such an aggressive approach has been considered cost-effective for high-risk patients. The diagnosis of CD among patients with extraintestinal symptoms requires a high degree of awareness of the clinical conditions that carry a high risk for underlying CD. Also, understanding the correct use of specific serology and duodenal histology is key for an appropriate diagnostic approach. Both procedures combined are able to confirm diagnosis in the vast majority of cases. However, in certain circumstances, serology and even duodenal histology cannot confirm or rule out CD. A common cause of negative IgA serology is IgA deficiency. For such eventuality, IgG-based serological tests can help confirm the diagnosis. Importantly, some histologically diagnosed cases still remain seronegative despite exclusion of IgA deficiency. On the other hand, duodenal histology may be normal despite the presence of CD-specific antibodies and active CD. This has been clearly demonstrated in some cases of untreated dermatitis herpetiformis, but may also be due to the patchy condition of CD or lesions that are not adequately recognized by nonexpert endoscopists and/or pathologists. The effectiveness of agluten-free diet depends on the clinical end point addressed. A good example is the outcome of bone loss. While risk for fracture normalizes after the first year of dietary treatment, bone parameters measured by densitometry may not be normalized in the long-term follow-up. Moreover, it is still unclear how far an early gluten-free diet will positively affect associated autoimmune diseases like type 1 diabetes and autoimmune thyroiditis.

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Section: Mucocutaneous Manifestations Of CDmentioning

confidence: 99%

Extraintestinal Manifestations of Celiac Disease

Pinto-Sanchez¹,

Berčík²,

Verdú³

et al. 2015

Dig Dis

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“…Some cases of alopecia areata associated with CD have been reported [132–134]. The administration of a GFD to these patients has variable results, and not in all cases, the recovery of hair growth with the diet [133] has been described.…”

Section: Autoimmune Disorders In Celiac Diseasementioning

confidence: 99%

Celiac Disease and Autoimmune-Associated Conditions

Lauret

Rodrigo

2013

BioMed Research International

145

111

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Celiac disease (CD) is frequently accompanied by a variety of extradigestive manifestations, thus making it a systemic disease rather than a disease limited to the gastrointestinal tract. This is primarily explained by the fact that CD belongs to the group of autoimmune diseases. The only one with a known etiology is related to a permanent intolerance to gluten. Remarkable breakthroughs have been achieved in the last decades, due to a greater interest in the diagnosis of atypical and asymptomatic patients, which are more frequent in adults. The known presence of several associated diseases provides guidance in the search of oligosymptomatic cases as well as studies performed in relatives of patients with CD. The causes for the onset and manifestation of associated diseases are diverse; some share a similar genetic base, like type 1 diabetes mellitus (T1D); others share pathogenic mechanisms, and yet, others are of unknown nature. General practitioners and other specialists must remember that CD may debut with extraintestinal manifestations, and associated illnesses may appear both at the time of diagnosis and throughout the evolution of the disease. The implementation of a gluten-free diet (GFD) improves the overall clinical course and influences the evolution of the associated diseases. In some cases, such as iron deficiency anemia, the GFD contributes to its disappearance. In other disorders, like T1D, this allows a better control of the disease. In several other complications and/or associated diseases, an adequate adherence to a GFD may slow down their evolution, especially if implemented during an early stage.

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“…CD may be associated with various skin manifestations, such as dermatitis herpetiformis (DH), psoriasis, alopecia areata and vitiligo [39][40][41]. DH is most frequently found in adolescents, young and middle-aged adults.…”

Section: Celiac Disease and Dermatological Diseasesmentioning

confidence: 99%