vitamin-b-12 and Dermatitis-Herpetiformis

Topics: Abetalipoproteinemia; Agammaglobulinemia; Animals; Bile Acids and Salts; Biological Transport; Biopsy; Carbohydrate Metabolism; Celiac Disease; Deficiency Diseases; Dermatitis Herpetiformis; Digestion; Endocrine System Diseases; Glutens; Glycoside Hydrolases; Histocytochemistry; Humans; Intestinal Absorption; Intestinal Diseases, Parasitic; Intestinal Mucosa; Intestine, Small; Intestines; Lymphatic Diseases; Malabsorption Syndromes; Methods; Monosaccharides; Protein-Losing Enteropathies; Psoriasis; Radiography; Sprue, Tropical; Vitamin B 12; Whipple Disease

Nutritional status of 86 patients with dermatitis herpetiformis (DH) was defined by anthropometric measurements and hematological and biochemical laboratory tests to establish prevalence of malabsorption and malnutrition. Anthropometric measurements in DH patients were comparable to normal control patients. Four individuals were of short stature; two had had diarrhea and failed to thrive in childhood. Abnormalities attributable to nutritional deficiency were detected in only 6 of the 86, whereas drug-associated hematological or biochemical changes were present in 36 of 55 subjects treated with dapsone or sulfapyridine. Twenty patients had hemolytic anemia or macrocytosis related to drug therapy. Only two had anemias attributable to malabsorption; one was iron deficient, the other folate deficient. Two other patients were mildly Fe deficient and two had slight folate deficiency; they lacked other stigmata of malabsorption. Drug-induced hematological and biochemical abnormalities were more common than changes that suggest nutritional disease, even though most DH patients had an enteropathy at presentation.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Alkaline Phosphatase; Biopsy; Blood Proteins; Body Height; Calcium; Dermatitis Herpetiformis; Female; Humans; Jejunum; Magnesium; Male; Middle Aged; Nutritional Status; Vitamin B 12

A young man with dermatitis herpetiformis developed fatigue and neurologic complaints 4 years after he began oral dapsone therapy. Neurologic examination and nerve conduction studies confirmed the presence of a combined motor and sensory peripheral neuropathy. The symptomatic improvement reported by the patient was supported by improvement in the nerve conduction studies after cessation of dapsone therapy. Substitution of sulfapyridine did not adversely affect the resolution of his neuropathy.

Topics: Administration, Oral; Adult; Dapsone; Dermatitis Herpetiformis; Humans; Injections, Intramuscular; Male; Peripheral Nervous System Diseases; Prednisone; Sulfapyridine; Time Factors; Vitamin B 12; Vitamins

Serum vitamin B12 concentrations were determined in 129 patients and a pentagastrin test performed in 116 patients with dermatitis herpetiformis (DH). Low serum vitamin B12 levels were found in 27 patients (21%) and achlorhydria in 30. Forty-two patients with achlorhydria and/or vitamin B12 deficiency were subjected to further haematological and gastrointestinal investigations. Functional or morphological involvement of the small intestine was seen in almost all patients with vitamin B12 deficiency but, in addition, atrophic gastritis resulting in defective secretion of intrinsic factor (pernicious anaemia) was found in 8 cases (7% of all DH patients). Thus, a low vitamin B12 level in DH patients should result in a careful gastrointestinal examination as both an atrophic gastritis and a coeliac-like enteropathy have further clinical implications.

Topics: Achlorhydria; Adult; Aged; Anemia, Pernicious; Dermatitis Herpetiformis; Female; Gastritis, Atrophic; Humans; Intestines; Male; Middle Aged; Vitamin B 12; Vitamin B 12 Deficiency

Iron absorption has been studied in patients with dermatitis herpetiformis (DH). Four patients out of 20 had iron deficiency, defined as absence of or only traces of haemosiderin in bone marrow smears. These four had adequate absorption of ferrous iron. The iron deficiency in at least 3 of them was ascribed to increased iron loss. The results indicate that, although having a mild to moderate malabsorption syndrome, DH patients can be expected to exhibit adequate absorption of orally administered iron. Explanations of a negative iron balance other than defective absorption should therefore be sought.

Topics: Adolescent; Adult; Aged; Anemia, Hypochromic; Dermatitis Herpetiformis; Female; Folic Acid; Gastric Juice; Haptoglobins; Hemoglobins; Hemosiderin; Humans; Intestinal Absorption; Iron; Male; Middle Aged; Vitamin B 12

Five of 33 patients with dermatitis herpetiformis (DH) were found to have gastric parietal cell antibody in their sera, whereas it was not found in 30 healthy controls of comparable age distribution. Fifteen of the patients with DH underwent further studies to investigate the histological and functional state of their gastric mucosa. Atrophic gastritis was found in all five patients whose sera contained gastric parietal cell antibody and in three of 11 patients with no antibody in their sera. In addition, there was marked impairment of acid secretion in the DH group as a whole, but, apart from one patient with overt pernicious anaemia (PA), there was no evidence of malabsorption of B12.

Topics: Adolescent; Adult; Aged; Anemia, Pernicious; Atrophy; Autoantibodies; Dermatitis Herpetiformis; Female; Fluorescent Antibody Technique; Gastric Juice; Gastric Mucosa; Gastritis; Humans; Male; Middle Aged; Pentagastrin; Schilling Test; Vitamin B 12

Thirty-seven patients with dermatitis herpetiformis (DH) have been investigated for gastric and small intestinal abnormalities. Evidence of an enteropathy was found in 86% of the patients who had IgA deposits in uninvolved skin. Villous atrophy of the small intestine was found in 29 patients. About one-half of the patients had reduced absorption of xylose and vitamin A. The Schilling test value was lowered in one-third. Serum B12 was too low in 5/28 patients whereas folic acid in serum and whole blood was too low in 14/29 and 5/19, respectively. Atrophic gastritis occurred in 14/28 patients and only about one-third of the whole patient material had normal gastric mucosal structure and secretion.

Topics: Adolescent; Adult; Aged; Dermatitis Herpetiformis; Female; Folic Acid; Gastric Acidity Determination; Gastric Juice; Humans; Intestinal Absorption; Intestinal Mucosa; Intestinal Secretions; Male; Middle Aged; Vitamin A; Vitamin B 12; Xylose

Topics: Adult; Atrophy; Dermatitis Herpetiformis; Dietary Carbohydrates; Female; Glutens; Humans; Intestinal Absorption; Intestinal Mucosa; Intestine, Small; Malabsorption Syndromes; Male; Middle Aged; Vitamin B 12; Xylose

Topics: Biopsy; Celiac Disease; Cobalt Radioisotopes; Colitis, Ulcerative; Colostomy; Crohn Disease; Dermatitis Herpetiformis; Gastric Juice; Gastric Mucosa; Gastritis; Humans; Ileostomy; Intestinal Absorption; Jejunum; Obesity; Pentagastrin; Schilling Test; Secretory Rate; Stimulation, Chemical; Vitamin B 12

Topics: Anemia, Pernicious; Dermatitis Herpetiformis; Female; Humans; Hyperthyroidism; Immunoglobulin M; Intestinal Mucosa; Iron; Jejunum; Middle Aged; Vitamin B 12

Topics: Adult; Aged; Biopsy; Celiac Disease; Child; Dapsone; Dermatitis Herpetiformis; Female; Folic Acid; Humans; Intestinal Absorption; Intestine, Small; Jejunum; Malabsorption Syndromes; Male; Middle Aged; Prednisone; Schilling Test; Sulfonamides; Vitamin B 12

Topics: Adult; Aged; Biopsy; Dermatitis Herpetiformis; Diet Therapy; Dipeptidases; Dipeptides; Fats; Feces; Female; FIGLU Test; Folic Acid; Gastrointestinal Diseases; Glutens; Glycoside Hydrolases; Hemoglobinometry; Histocytochemistry; Humans; Intestinal Mucosa; Intestine, Small; Male; Middle Aged; Vitamin B 12; Xylose

Topics: Biopsy; Celiac Disease; Dermatitis Herpetiformis; Female; Humans; Intestinal Mucosa; Jejunum; Male; Middle Aged; Protein-Losing Enteropathies; Vitamin A; Vitamin B 12; Xylose

Topics: Adult; Aged; Anemia, Hemolytic; Anemia, Hypochromic; Anemia, Pernicious; Dapsone; Dermatitis Herpetiformis; Folic Acid; Hemolysis; Humans; Iron; Malabsorption Syndromes; Middle Aged; Oxygen; Vitamin B 12

Topics: Achlorhydria; Dermatitis Herpetiformis; Gastritis; Humans; Malabsorption Syndromes; Pemphigus; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Biopsy; Dapsone; Dermatitis Herpetiformis; Diet Therapy; Fats; Feces; Female; Folic Acid; Glutens; Humans; Intestine, Small; Male; Vitamin B 12

Topics: Adult; Biopsy; Blood Cell Count; Bone Marrow Cells; Dapsone; Dermatitis Herpetiformis; Diet Therapy; Fats; Feces; Female; Folic Acid; Glutens; Hemoglobinometry; Humans; Intestinal Mucosa; Intestine, Small; Iron; Male; Middle Aged; Skin Manifestations; Vitamin B 12

Topics: Adolescent; Adult; Aged; Biopsy; Bone Marrow Examination; Dapsone; Dermatitis Herpetiformis; Diarrhea; Diet Therapy; Female; Folic Acid; Glutens; Humans; Intestinal Mucosa; Jejunum; Malabsorption Syndromes; Male; Middle Aged; Vitamin B 12