Abstract
Sera of 44 children with dermatitis herpetiformis with granular IgA deposits in the papillary dermis were investigated on cryostat sections of normal jejunum of three children aged 2 months, 1 year, and 10 years by indirect immunofluorescence. Eighteen of 25 patients on a normal diet had an IgA class antibody showing the following staining patterns on substrate jejunums: tubular positivity in the lamina propria--around the crypts, beneath the villous epithelial basement membrane, and in some instances in the middle of the villous also, following the capillary system of villi; coalescence of tubular positivity at the muscularis mucosae; and positive blood vessels and smooth muscle endomysium. Eleven of 18 children with positive sera were put on a gluten-free diet (GFD) and their sera became negative. One of these 11 patients was challenged with gluten and the antibody reappeared. Nineteen patients examined only on a GFD and 30 healthy blood donors did not have this antibody. There was no strict correlation between the titer of antibody and the severity of jejunal mucosal damage.
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