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Bone Loss Common in Dermatitis Herpetiformis

Celiac.com 11/13/2013 - Dermatitis herpetiformis is the cutaneous manifestation of celiac disease. Both celiac and dermatitis herpetiformis are diseases of gluten-sensitivity.

Photo: CC--_chrisUKPeople with celiac disease, even with asymptomatic forms, often experience reduced bone density from metabolic bone disease. This led scientists to ask if dermatitis herpetiformis results in bone loss as celiac disease does.

However, there is very little data about bone density in patients with dermatitis herpetiformis, so that question remained unanswered.

To find an answer, a team of researchers recently set out to compare bone mineral density (BMD) of people with celiac disease against bone mineral density for dermatitis herpetiformis patients.

The research team included K. Lorinczy, M. Juhász, M. Csontos, B. Fekete, O. Terjék, P.L. Lakatos, P. Miheller, D. Kocsis, S. Kárpáti, Z. Tulassay, and T. Zágoni.

The team looked at 34 people with celiac disease, 53 with dermatitis herpetiformis, and 42 healthy people as a control group. The average patient age was 38.0 +/- 12.1 for the celiac disease group, 32.18 +/- 14.95 for the dermatitis herpetiformis group, and 35.33 +/- 10.41 years for the healthy control group.

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For each group, the team used dual-energy X-ray absorptiometry to measure bone mineral density of the lumbar spine, the left femoral neck and radius.

The team defined low bone density, osteopenia and osteoporosis as a body mass density (BMD) T-score between 0 and -1, between -1 and -2.5, and under -2.5, respectively.

In the lumbar region, the team found decreased BMD in 49% of the patients with dermatitis herpetiformis, in 62% of the patients with celiac disease, and in 29% of healthy control subjects.

Overall, they measured lower BMD at the lumbar region in people with dermatitis herpetiformis and celiac disease than in the healthy subjects (0.993 +/- 0.136 g/cm2 and 0.880 +/- 0.155 g/cm2 vs. 1.056 +/- 0.126 g/cm2; p < 0.01).

There was no difference in density of bones composed of dominantly cortical compartment (femoral neck) in dermatitis herpetiformis and healthy subjects.

This study shows that low bone mass is common in patients with dermatitis herpetiformis, and that bone mineral density for these patients is significantly lower in those bones with more trabecular than cortical composition.

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That's what I thought! My father has gluten sensitivity and I almost regret telling the doctor that because I feel that made her jump to conclusions because of that. He never had the biopsy either. I feel like doctors think it's just easier to say it's celiac when they show a gluten sensitivity to avoid additional testing, even if that diagnosis doesn't make any sense at all. My doctor didn't even offer the biopsy, and said the blood work was enough. Should I seek a third opinion? I mean, I've been gluten free for 9 months...

It will prolong your life....celiac is a autoimmune disease that causes your own immune system to attack you. The longer your eating gluten the worse it gets, I mean all kinds of other autoimmune disease, food allergies, food intolances. One day you could lose the ablity to eat carbs, or sugars, or become randomly allergic to tomatoes or corn all cause you decided not to be on road to healing I am not kidding here. I am allergic to corn, can not process meats, have another autoimmune disease that makes it so I can not eat dairy or CARBS/SUGARS. I wish I could go back in time and go on a gluten-free diet a decade ago. Worse that could happen you could develop cancer or other complications and yes we have had this happen to a member before on our forums. Think of it like this your just changing brand here I will give you some links to some gluten-free foods, and how to order them, You can even order alot of them online this should help simplify it for you. I suggest thrive, amazon, or one of hte other links from there, Many you can order from the manufacture. https://www.celiac.com/gluten-free/topic/117090-gluten-free-food-alternatives-list/

I know this is not funny for you guys, but I had to laugh about how all of those family members simply ignored your well meant advice. That is definitely head in the sand syndrome. I have tried for a long time to find the connection between autoimmune diseases and my health. With this celiac diagnosis I have finally found it. All of the puzzle pieces are in place for sure and it is going to be my mission to do the best possible in order to get healthy again. What a sneaky disease this is and to think that none of my family members never were diagnosed, despite the fact that both have been in doctor's care all of their lives. It really goes to show that most medical doctors simply seem to completely disconnect nutrition with health. I am scared to give that advice to people when I see them suffering from specific diseases. But there are people that I would like to help if I can. Scared to make those suggestions, because so many times negative reactions follow and all I meant to do was to help that person.

There are definitely things you can do to make it easier on yourself. But all of my ideas seem to cost money and involve cooking. But I'll give it a shot anyway in case you haven't already thought of it. I would buy a small chest freezer and put gluten-free foods in it. Canyon bakehouse sells their fantastic bread and bagels right on their website. You can just buy a case of it. Then if you ever get in the mood for a sandwich or bagel the bread's right there frozen in your chest freezer. If you get invited to somebody's house for dinner find out what their cooking and make your own similar version of it. So for Easter I would make ham, potatoes and broccoli and bring that with me. So when everybody else is eating a fantastic Easter dinner I'm also eating a fantastic Easter dinner. I have other food issues and before celiac I was invited to a friend's wedding. I wasn't going to be able to eat the food they were serving so I made similar food at home. They were serving lamb, ham, vegetables, potatoes. So I brought ham, corn and potatoes with me and heated it up when everybody was going to the buffet to get their food. So when everybody else was pigging out on this great wedding dinner I was also pigging out on a great dinner. And nobody would have noticed if they didn't try. Sometimes you just get in the mood to have a frozen dinner and just don't feel like cooking something. There's two ways you can go about this. I happen to be addicted to Udi's chicken Florentine and think that their broccoli kale lasagna is very good as well. So I'd stock up on that in that chest freezer. glutenfreemall.com has tons of stuff. On Sunday you can make a weeks worth of food and freeze a lot of it in individual portions. After a few weeks you will have several different meals in the chest freezer that you made at home. You can eat those on weeknights when you're too busy to cook. In my family Friday night was always eat out fast food night. McDonald's, Burger King, pizza, fried chicken. So for pizza my plan is to purchase Etalia New York style pizza crusts. Purchase some Escalon six in one crushed tomatoes and freeze in individual portions. Buy some Grande 50/50 mozzarella cheese and freeze in individual portions as well. If on Friday night if I am in the mood for pizza I'll just grab a crust, a portion of sauce and a portion of cheese from the chest freezer and make myself pizza in under 15 minutes. When I get invited to a barbecue I bring loaded potato skins or batter fried chicken wings. Everybody loves them as do I. I by Pamela's gluten-free flour from Amazon six at a time. So I always have some available. For the record, at the moment I am an extremely strict diet and cannot do any of the above. But will go back to that method in a few months.

Yes, I remember as a child being very ill too, could never explain it. The fact that I have several autoimmune diseases speaks volumes. I sure wish I had caught this much sooner. Will have to research to increase enzyme consumption, but we can not look into our digestive system. Trying to concentrate on repairing the damage, not much else that can be done right now.