Latent Celiac Sprue

Abstract

This study shows that patients with dermatitis herpetiformis (DH) and morphologically normal small intestinal mucosa may have a latent form of celiac sprue. Two patients with DH and one normal volunteer, all of whom had morphologically normal small intestinal mucosa, were placed on a high gluten diet for 22 to 30 weeks. Moderately abnormal and severe flat mucosal lesions were induced in both patients with DH, but not in the normal volunteer. Neither patient with DH developed clinical or laboratory evidence of malabsorption. On completion of the high gluten diet, 1 patient with DH was studied on a normal gluten-containing diet, and his intestinal mucosa reverted toward normal by 16 weeks. Latent celiac sprue may be defined as a condition in which the intestinal mucosa becomes unequivocally abnormal in response to increased dietary gluten.