Extraintestinal (dermatological) manifestations of malabsorption syndrome and celiac disease

Abstract

The aim of the study was to estimate the clinical characteristics of extraintestinal (dermatological) symptoms of celiac disease and malabsorption syndrome. Materials and methods : the work is based on the results of the determination of antibodies to deamidated peptides of gliadin (AGA IgA, IgG) and tissue transglutaminase (tTG IgA, IgG) in whole blood by enzyme immunoassay method (ELISA). During the three-year period, 1367 patients with common chronically dermatoses were examined. Results : Positive reactions to antibodies to deamidated peptides of gliadin and/or tissue transglutaminase were detected in 229 patients (117 men and 112 women aged from 18 to 70 years), which accounted for 16.8% of the total number of patients examined. Of the 229 seropositive patients, 47 suff ered from psoriasis, 27 — allergic dermatitis, 24 — lichen planus, 21 — atopic dermatitis, 19 — eczema, 14 — acne, 13 — focal neurodermatitis, 11 — herpetiform Düring dermatitis, 11 — seborrheic dermatitis, 9 — urticaria, 9 — alopecia, 9 — scleroderma, 8 — rosacea, 7 — discoid lupus erythematosus. Clinical signs of celiac disease (nausea, loose stools with foul odor, bloating) were observed only in 149 out of 229 seropositive patients (65%). In 80 patients (35%) there were no clinical signs of gastrointestinal tract damage. Conclusion : in some cases, celiac disease is latent and atypical, often dermatological symptoms are the fi rst and only clinical manifestations of the syndrome of malabsorption and celiac disease. The most common symptoms in patients with celiac disease are: Dühring dermatitis; xerosis and peeling of the skin, follicular hyperkeratosis, fi ssures, pellagroid pigmentation, nail atrophy, focal alopecia; severe, often relapsing course of psoriasis, allergic and atopic dermatitis, eczema, lichen planus.