Jump to content
  • Welcome to Celiac.com!

    You have found your celiac tribe! Join us and ask questions in our forum, share your story, and connect with others.




  • Celiac.com Sponsor (A1):



    Celiac.com Sponsor (A1-M):


  • Get Celiac.com Updates:
    Support Our Content
    eNewsletter
    Donate

Does this look like d.h.?


Laurel F

Recommended Posts

Laurel F Rookie

Hi, I have been trying to get a celiac diagnosis for awhile now. I had an endoscopy years ago that showed flatted villi but the biopsy said "possible sprue or possible duodonitis." I went g.f. and had another test a few years later. The villi were normal but I had what I thought was a d.h. rash. The dermatologist said it did not look like d.h. and said it was just eczema. 

To test myself, I started eating gluten again. I have occasional bowel issues but not like I had years ago.

Now my legs look like I have d.h. again. 

Does it look like d.h.? Should I push for yet another endoscopy or just diagnose myself? I do not want to have to limit gluten from my diet unnecessarily because my son has life-threatening allergies to several foods which we strictly avoid. It was hard to cook avoiding gluten while avoiding all his allergens, too.

 

Thanks! 

leg.small.webp


Celiac.com Sponsor (A8):
Celiac.com Sponsor (A8):



Celiac.com Sponsor (A8-M):



Wheatwacked Veteran

Sprue is another name for Celiac Disease. Your eczema could be caused by a vitamin D deficiency as a result of comorbid malabsorption syndrome. Google it. Regardless of cause, you appear to do better without the gluten and your doctors cannot explain. Your biopsy showed improvement with GFD and your rash returned when you eat it. It seems like a no brainer, except that massive advertising has convinced us that wheat is a vital part of our diet. The only essential nutrition from wheat products are the added vitamins and some calories. So, what is important, your diagnosis or your well being? I suggest going gluten free and finding a physician not in denial about the effects of malnutrition. The advantage of modern wheat is that it will continue to increase yield as long as you give it water and fertilizer. Could those same proteins be the cause of the fattening of America?

Quote

The digestion of proteins, carbohydrates, and lipids is compromised due to decreased pancreatic and biliary secretion. The absorption of the digestive products is also severely affected due to decreased activity of microvillus enzymes (dipeptidases and disaccharidases) Tropical sprue is cured by treatment with tetracycline and folic acid, whereas nontropical sprue responds to a gluten-free diet. Nontropical sprue is associated with dermatitis herpetiformis by common genetic and morphological features, and the skin lesions in dermatitis herpetiformis are also responsive to a gluten-free diet. Finally, there appears to be an increased incidence of intestinal malignancies (lymphoma, adenocarcinoma) in nontropical sprue. https://www.ncbi.nlm.nih.gov/pubmed/3909813

 

cyclinglady Grand Master

There is no cure for celiac disease which is an autoimmune disorder.    The only cure for celiac disease and Dermatitis Herpetiformis (skin form)  is a strict gluten free diet.    Although not immediately life-threatening, celiac can kill.  Children used to die from it due to malnutrition back before WWI.  

It is possible to live carefully in a shared kitchen. Baking with wheat flour is not recommended as it can hang in the air.  You can breathed it in and swallow it causing an autoimmune flare up.  

You have a firm diagnosis.  You even were able to heal that villi!  What more proof do you need?  DH sufferers even have to be more careful.  I guess maybe not if you can stand the horrible itching and sincerely hope it does not spread to the rest of your body.  But know that you can go on to develop additional autoimmune  disorders like Type 1 diabetes (it is no longer called juvenile diabetes), autoimmune thyroid, lupus, Rheumatoid Arthritis, ......just pick one of many.  I have three autoimmune and I am working like crazy to prevent more from developing by at least keeping my celiac disease in remission. Your risk for intestinal cancer goes up too!  

I am a mother.  I get the allergies.  I have them and my family is riddled with them (EPI pens stashed everywhere), but a sick or dead mother is useless to her child.   Harsh?  Maybe.  But my first concern actually is your child!  BTW, get him tested!  I never tested positive to wheat on any allergy (IgE) testing!  Wheat  allergies and celiac disease are not the same.  You can even have both.

Please read through the DH section of the forum.  There is a lot of valuable advice.

Get help.  Ask to see a dietitian who can help you work safely in your kitchen.  Please take care of yourself!  

 

squirmingitch Veteran
On 2/11/2019 at 9:42 AM, Laurel F said:

To test myself, I started eating gluten again. I have occasional bowel issues but not like I had years ago.

It looks like dh but there are many skin conditions that can look like dh. I can clearly see that you are scratching it like mad which means it's itching like mad & dh is called the suicidal itch. 

But here's the thing....in your statement I quoted above, you say you don't have bowel issues like you did years ago. With dh, we tend NOT to have as many or as severe GI issues b/c the antibodies have deposited under our skin. We still have gut damage but it tends to be patchier than celiacs who do not have dh.

Cyclinglady has great advice for you. You should heed it.

GFinDC Veteran

Hi Laurel,

DH is diagnosed by taking a small biopsy sample of skin next to (but not on) a skin lesion.  You can go to a dermatologist for testing.  You don't need an endoscopy to test for DH.  DH is a presentation of celiac where the antibodies attack the skin.

Some of us have additional food intolerances beyond just gluten.  There is a possibility that the longer we have uncontrolled irritation/inflammation in our GI tract, the more foods we can become intolerant to.

https://duckduckgo.com/?q=dermatologist+celiac+in+massachusetts+today&t=h_&ia=web

 

Posterboy Mentor
On 2/11/2019 at 8:42 AM, Laurel F said:

Does it look like d.h.? Should I push for yet another endoscopy or just diagnose myself? I do not want to have to limit gluten from my diet unnecessarily because my son has life-threatening allergies to several foods which we strictly avoid. It was hard to cook avoiding gluten while avoiding all his allergens, too.

Laurel,

We can't diagnosis or treat you but here is some research that might help you decide what is best for you. ..it explains very well how it is diagnosed entitled 'Dermatitis herpetiformis: pathophysiology, clinical presentation, diagnosis and treatment*"

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4230654/

what struck me about this research was their notes on correlated diseases IE related conditions that also may be causing your DH like symptom's. ... they say recent research has linked chronic gastritis to DH.

Here is the research for that link entitled "Chronic gastritis in dermatitis herpetiformis: a controlled study."

https://www.ncbi.nlm.nih.gov/pubmed/22611420

I don't know if this helps you are not  ....but it would be consistent your past GI problems. At least it is good to know it not all in your mind!

I hope this is helpful but it is is not medical advice.

2 Timothy 2: 7 “Consider what I say; and the Lord give thee understanding in all things” this included.

Posterboy by the Grace of God,

squirmingitch Veteran
9 hours ago, GFinDC said:

Hi Laurel,

DH is diagnosed by taking a small biopsy sample of skin next to (but not on) a skin lesion.  You can go to a dermatologist for testing.  You don't need an endoscopy to test for DH.  DH is a presentation of celiac where the antibodies attack the skin.

Some of us have additional food intolerances beyond just gluten.  There is a possibility that the longer we have uncontrolled irritation/inflammation in our GI tract, the more foods we can become intolerant to.

https://duckduckgo.com/?q=dermatologist+celiac+in+massachusetts+today&t=h_&ia=web

 

The problem with Laurel getting a dh biopsy is that it requires her to do a gluten challenge just as if she were going to get a celiac serum panel. The same challenge parameters are required.


Celiac.com Sponsor (A8):
Celiac.com Sponsor (A8):



Celiac.com Sponsor (A8-M):



cyclinglady Grand Master
On 2/11/2019 at 6:42 AM, Laurel F said:

Hi, I have been trying to get a celiac diagnosis for awhile now. I had an endoscopy years ago that showed flatted villi but the biopsy said "possible sprue or possible duodonitis." I went g.f. and had another test a few years later. The villi were normal but I had what I thought was a d.h. rash. The dermatologist said it did not look like d.h. and said it was just eczema. 

To test myself, I started eating gluten again. I have occasional bowel issues but not like I had years ago.

Now my legs look like I have d.h. again. 

Does it look like d.h.? Should I push for yet another endoscopy or just diagnose myself? I do not want to have to limit gluten from my diet unnecessarily because my son has life-threatening allergies to several foods which we strictly avoid. It was hard to cook avoiding gluten while avoiding all his allergens, too.

 

Thanks! 

leg.small.webp

If you had flattened villi and they recovered on a gluten free diet, you have celiac disease and not one of the many other things that can cause villi damage.    If you have celiac disease, chances are that rash is DH.  DH is celiac disease.  

GFinDC Veteran

Hi Laurel,

Has your son been tested for celiac disease?  Allergic reactions can be elevated by celiac disease.  At least in my case they were.  I had bad allergies that decreased a lot after going gluten-free.  My theory is the immune system is in overdrive because of celiac disease and so allergy type reactions are kicked up also.  And since celiac disease is gene related, it is important to get all first degree blood relatives tested.

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now
  • Get Celiac.com Updates:
    Support Celiac.com:
    Join eNewsletter
    Donate

  • Celiac.com Sponsor (A17):
    Celiac.com Sponsor (A17):





    Celiac.com Sponsors (A17-M):




  • Recent Activity

    1. - suek54 replied to suek54's topic in Dermatitis Herpetiformis
      7

      Awaiting dermatitis herpetiformis confirmation following biopsy

    2. - knitty kitty replied to suek54's topic in Dermatitis Herpetiformis
      7

      Awaiting dermatitis herpetiformis confirmation following biopsy

    3. - suek54 replied to suek54's topic in Dermatitis Herpetiformis
      7

      Awaiting dermatitis herpetiformis confirmation following biopsy

    4. - trents replied to catnapt's topic in Celiac Disease Pre-Diagnosis, Testing & Symptoms
      3

      how much gluten do I need to eat before blood tests?

    5. - catnapt replied to catnapt's topic in Celiac Disease Pre-Diagnosis, Testing & Symptoms
      3

      how much gluten do I need to eat before blood tests?

  • Celiac.com Sponsor (A19):
  • Member Statistics

    • Total Members
      133,258
    • Most Online (within 30 mins)
      7,748

    Tdodge
    Newest Member
    Tdodge
    Joined
  • Celiac.com Sponsor (A20):
  • Celiac.com Sponsor (A22):
  • Forum Statistics

    • Total Topics
      121.6k
    • Total Posts
      1m
  • Celiac.com Sponsor (A21):
  • Upcoming Events

  • Posts

    • suek54
      Wow KK, thank you so much for all your attached info. I had a very quick scan but will read more in depth later.  The one concerning corticosteroid use is very interesting. That would relate to secondary adrenal insufficiency I think , ie AI caused by steroids such as taken long term for eg asthma. I have primary autoimmune AI, my adrenals are atrophied, no chance if recovery there. But I am in touch with some secondaries, so something to bear in mind. .  Niacin B3 Very interesting too. Must have a good read about that.  Im sure lots of questions will arise as I progress with dermatitis herpetiformis. In the mean time, thanks for your help.
    • knitty kitty
      Welcome to the forum, @suek54, I have Dermatitis Herpetiformis, too.  I found taking Niacin B3 very helpful in clearing my skin from blisters as well as improving the itchies-without-rash (peripheral neuropathy).  Niacin has been used since the 1950's to improve dermatitis herpetiformis.   I try to balance my iodine intake (which will cause flairs) with Selenium which improves thyroid function.   Interesting Reading: Dermatitis herpetiformis effectively treated with heparin, tetracycline and nicotinamide https://pubmed.ncbi.nlm.nih.gov/10844495/   Experience with selenium used to recover adrenocortical function in patients taking glucocorticosteroids long https://pubmed.ncbi.nlm.nih.gov/24437222/   Two Cases of Dermatitis Herpetiformis Successfully Treated with Tetracycline and Niacinamide https://pubmed.ncbi.nlm.nih.gov/30390734/   Steroid-Resistant Rash With Neuropsychiatric Deterioration and Weight Loss: A Modern-Day Case of Pellagra https://pmc.ncbi.nlm.nih.gov/articles/PMC12532421/#:~:text=Figure 2.,(right panel) upper limbs.&text=The distribution of the rash,patient's substantial response to treatment.   Nicotinic acid therapy of dermatitis herpetiformis (1950) https://pubmed.ncbi.nlm.nih.gov/15412276/
    • suek54
      Thank you all for your advice and the dermatitis herpetiformis article. The latter made me realise I had stopped taking my antihistamine, which I will restart today. The Dapsone has cleared the rash entirely but I still get quite a bit itching, absolutely nothing to see though. I know its notoriously hard to clear and its still relatively early days for me.  The iodine issue is very interesting. I do eat quite a bit of salt because I have Addison's disease and sodium retention is an issue. I also have autoimmune hypothyroidism, not sure how a low iodine diet would play into that? Because of my Addison's I am totally steroid dependent, I take steroids 4 x daily and cannot mount any defence against inflammation. I need to increase my meds for that. Now that I know what is wrong I can do just that if Im having a bad day. Life is very sweet, just so damn complicated sometimes! Hey ho, onwards. Thank you again for your advice.  
    • trents
      So, essentially all of the nutrition in the food we eat is absorbed through the villous lining of the small bowel. This is the section of the intestinal track that is damaged by celiac disease. This villous lining is composed of billions of finger-like projections that create a huge amount of surface area for absorbing nutrients. For the celiac person, when gluten is consumed, it triggers an autoimmune reaction in this area which, of course, generates inflammation. The antibodies connected with this inflammation is what the celiac blood tests are designed to detect but this inflammation, over time, wears down the finger-like projections of the villous lining. Of course, when this proceeds for an extended period of time, greatly reduces the absorption efficiency of the villous lining and often results in many and various nutrient deficiency-related health issues. Classic examples would be osteoporosis and iron deficiency. But there are many more. Low D3 levels is a well-known celiac-caused nutritional deficiency. So is low B12. All the B vitamins in fact. Magnesium, zinc, etc.  Celiac disease can also cause liver inflammation. You mention elevated ALP levels. Elevated liver enzymes over a period of 13 years was what led to my celiac diagnosis. Within three months of going gluten free my liver enzymes normalized. I had elevated AST and ALT. The development of sensitivities to other food proteins is very common in the celiac population. Most common cross reactive foods are dairy and oats but eggs, soy and corn are also relatively common offenders. Lactose intolerance is also common in the celiac population because of damage to the SB lining.  Eggs when they are scrambled or fried give me a gut ache. But when I poach them, they do not. The steam and heat of poaching causes a hydrolysis process that alters the protein in the egg. They don't bother me in baked goods either so I assume the same process is at work. I bought a plastic poacher on Amazon to make poaching very easy. All this to say that many of the issues you describe could be caused by celiac disease. 
    • catnapt
      thank you so much for your detailed and extremely helpful reply!! I can say with absolute certainty that the less gluten containing products I've eaten over the past several years, the better I've felt.   I wasn't avoiding gluten, I was avoiding refined grains (and most processed foods) as well as anything that made me feel bad when I ate it. It's the same reason I gave up dairy and eggs- they make me feel ill.  I do have a bit of a sugar addiction lol so a lot of times I wasn't sure if it was the refined grains that I was eating - or the sugar. So from time to time I might have a cookie or something but I've learned how to make wonderful cookies and golden brownies with BEANS!! and no refined sugar - I use date paste instead. Pizza made me so ill- but I thought it was probably the cheese. I gave up pizza and haven't missed it. the one time I tried a slice I felt so bad I knew I'd never touch it again. I stopped eating wheat pasta at least 3 yrs ago- just didn't feel well after eating it. I tried chick pea pasta and a few others and discovered I like the brown rice pasta. I still don't eat a lot of pasta but it's nice for a change when I want something easy. TBH over the years I've wondered sometimes if I might be gluten intolerant but really believed it was not possible for me to have celiac disease. NOW I need to know for sure- because I'm in the middle of a long process of trying to find out why I have a high parathyroid level (NOT the thyroid- but rather the 4 glands that control the calcium balance in your body) I have had a hard time getting my vit D level up, my serum calcium has run on the low side of normal for many years... and now I am losing calcium from my bones and excreting it in my urine (some sort of renal calcium leak) Also have a high ALP since 2014. And now rapidly worsening bone density.  I still do not have a firm diagnosis. Could be secondary HPT (but secondary to what? we need to know) It could be early primary HPT. I am spilling calcium in my urine but is that caused by the high parathyroid hormone or is it the reason my PTH is high>? there are multiple feedback loops for this condition.    so I will keep eating the bread and some wheat germ that does not seem to bother me too much (it hasn't got enough gluten to use just wheat germ)    but I'm curious- if you don't have a strong reaction to a product- like me and wheat germ- does that mean it's ok to eat or is it still causing harm even if you don't have any obvious symptoms? I guess what you are saying about silent celiac makes it likely that you can have no symptoms and still have the harm... but geez! you'd think they'd come up with a way to test for this that didn't require you to consume something that makes you sick! I worry about the complications I've been reading about- different kinds of cancers etc. also wondering- are there degrees of celiac disease?  is there any correlation between symptoms and the amnt of damage to your intestines? I also need a firm diagnosis because I have an identical twin sister ... so if I have celiac, she has it too- or at least the genetic make up for having it. I did have a VERY major stress to my body in 2014-2016 time frame .. lost 50lbs in a short period of time and had severe symptoms from acute protracted withdrawal off an SSRI drug (that I'd been given an unethically high dose of, by a dr who has since lost his license)  Going off the drug was a good thing and in many ways my health improved dramatically- just losing 50lbs was helpful but I also went  off almost a dozen different medications, totally changed my diet and have been doing pretty well except for the past 3-4 yrs when the symptoms related to the parathyroid issue cropped up. It is likely that I had low vit D for some time and that caused me a lot of symptoms. The endo now tells me that low vit D can be caused by celiac disease so I need to know for sure! thank you for all that great and useful information!!! 
×
×
  • Create New...

Important Information

NOTICE: This site places This site places cookies on your device (Cookie settings). on your device. Continued use is acceptance of our Terms of Use, and Privacy Policy.