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. 1981 Jan;22(1):61–64. doi: 10.1136/gut.22.1.61

Cutaneous vasculitis complicating coeliac disease.

S Meyers, S Dikman, H Spiera, N Schultz, H D Janowitz
PMCID: PMC1419300  PMID: 7461477

Abstract

A 38 year old female, with chronic uncontrolled coeliac disease, presented with the rare complication of cutaneous leucocytoclastic vasculitis. Detailed study failed to identify any cause for the vasculitis, other than the underlying coeliac disease. Haematuria and proteinuria with mesangial nephritis were also demonstrated on renal biopsy with electron microscopic study. It is speculated that exogenous or endogenous antigens permeated the abnormal small bowel mucosa leading to formation of circulating immune complexes. Subsequent tissue deposition of these complexes then resulted in vasculitis and nephritis. The skin lesions cleared completely after treatment with a strict gluten free diet.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Alarcón-Segovia D. The necrotizing vasculitides. A new pathogenetic classification. Med Clin North Am. 1977 Mar;61(2):241–260. doi: 10.1016/s0025-7125(16)31330-x. [DOI] [PubMed] [Google Scholar]
  2. Booth C. C. The enterocyte in coeliac disease. Br Med J. 1970 Oct 3;4(5726):14–17. doi: 10.1136/bmj.4.5726.14. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Cotterill J. A., Cunliffe W. J., Bulusu L. Proteinuria associated with skin disease. Lancet. 1971 Aug 21;2(7721):403–405. doi: 10.1016/s0140-6736(71)90117-6. [DOI] [PubMed] [Google Scholar]
  4. DeCoteau W. E., Gerrard J. W., Cunningham T. A. Glomerulitis in dermatitis herpetiformis. Lancet. 1973 Sep 22;2(7830):679–680. doi: 10.1016/s0140-6736(73)92517-8. [DOI] [PubMed] [Google Scholar]
  5. Doe W. F., Evans D., Hobbs J. R., Booth C. C. Coeliac disease, vasculitis, and cryoglobulinaemia. Gut. 1972 Feb;13(2):112–123. doi: 10.1136/gut.13.2.112. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Falchuk Z. M., Strober W. Gluten-sensitive enteropathy: synthesis of antigliadin antibody in vitro. Gut. 1974 Dec;15(12):947–952. doi: 10.1136/gut.15.12.947. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Fauci A. S., Haynes B., Katz P. The spectrum of vasculitis: clinical, pathologic, immunologic and therapeutic considerations. Ann Intern Med. 1978 Nov;89(5 Pt 1):660–676. doi: 10.7326/0003-4819-89-5-660. [DOI] [PubMed] [Google Scholar]
  8. Ferguson A., MacDonald T. T., McClure J. P., Holden R. J. Cell-mediated immunity to gliadin within the small-intestinal mucosa in coeliac disease. Lancet. 1975 Apr 19;1(7912):895–897. doi: 10.1016/s0140-6736(75)91689-x. [DOI] [PubMed] [Google Scholar]
  9. Gilliam J. N., Smiley J. D. Cutaneous necrotizing vasculitis and related disorders. Ann Allergy. 1976 Nov;37(5):328–339. [PubMed] [Google Scholar]
  10. Green F. H., Carty J. E. Letter: Coeliac disease and autoimmunity. Lancet. 1976 May 1;1(7966):964–964. doi: 10.1016/s0140-6736(76)92742-2. [DOI] [PubMed] [Google Scholar]
  11. HOURIHANE D. O. DIARRHOEA OF SMALL BOWEL ORIGIN. THE HISTOLOGY OF INTESTINAL BIOPSIES. Proc R Soc Med. 1963 Dec;56:1073–1077. [PMC free article] [PubMed] [Google Scholar]
  12. Holdstock D. J., Oleesky S. Vasculitis in coeliac diseases. Br Med J. 1970 Nov 7;4(5731):369–369. doi: 10.1136/bmj.4.5731.369-a. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Jones F. A. The skin: a mirror of the gut. Geriatrics. 1973 Apr;28(4):75–81. [PubMed] [Google Scholar]
  14. Katz A., Dyck R. F., Bear R. A. Celiac disease associated with immune complex glomerulonephritis. Clin Nephrol. 1979 Jan;11(1):39–44. [PubMed] [Google Scholar]
  15. Marsh G. W., Stewart J. S. Splenic function in adult coeliac disease. Br J Haematol. 1970 Oct;19(4):445–457. doi: 10.1111/j.1365-2141.1970.tb06972.x. [DOI] [PubMed] [Google Scholar]
  16. Menzies I. S., Laker M. F., Pounder R., Bull J., Heyer S., Wheeler P. G., Creamer B. Abnormal intestinal permeability to sugars in villous atrophy. Lancet. 1979 Nov 24;2(8152):1107–1109. doi: 10.1016/s0140-6736(79)92507-8. [DOI] [PubMed] [Google Scholar]
  17. Mohammed I., Holborow E. J., Fry L., Thompson B. R., Hoffbrand A. V., Stewart J. S. Multiple immune complexes and hypocomplementaemia in dermatitis herpetiformis and coeliac disease. Lancet. 1976 Sep 4;1(7984):487–490. doi: 10.1016/s0140-6736(76)90787-x. [DOI] [PubMed] [Google Scholar]
  18. Moorthy A. V., Zimmerman S. W., Maxim P. E. Dermatitis herpetiformis and celiac disease: association with glomerulonephritis, hypocomplementia, and circulating immune complexes. JAMA. 1978 May 12;239(19):2019–2020. doi: 10.1001/jama.239.19.2019. [DOI] [PubMed] [Google Scholar]
  19. Sams W. M., Jr, Thorne E. G., Small P., Mass M. F., McIntosh R. M., Stanford R. E. Leukocytoclastic vasculitis. Arch Dermatol. 1976 Feb;112(2):219–226. [PubMed] [Google Scholar]
  20. Scott B. B., Losowsky M. S. Coeliac disease: a cause of various associated diseases? Lancet. 1975 Nov 15;2(7942):956–957. doi: 10.1016/s0140-6736(75)90365-7. [DOI] [PubMed] [Google Scholar]
  21. Scott B. B., Young S., Rajah S. M., Marks J., Losowsky M. S. Coeliac disease and dermatitis herpetiformis: further studies of their relationship. Gut. 1976 Oct;17(10):759–762. doi: 10.1136/gut.17.10.759. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. TAYLOR K. B., TRUELOVE S. C., THOMSON D. L., WRIGHT R. An immunological study of coeliac disease and idiopathic steatorrhoea. Serological reactions to gluten and milk proteins. Br Med J. 1961 Dec 30;2(5269):1727–1731. doi: 10.1136/bmj.2.5269.1727. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Wands J. R., LaMont J. T., Mann E., Isselbacher K. J. Arthritis associated with intestinal-bypass procedure for morbid obesity. Complement activation and characterization of circulating cryoproteins. N Engl J Med. 1976 Jan 15;294(3):121–124. doi: 10.1056/NEJM197601152940301. [DOI] [PubMed] [Google Scholar]
  24. Weinstein W. M., Saunders D. R., Tytgat G. N., Rubin C. E. Collagenous sprue--an unrecognized type of malabsorption. N Engl J Med. 1970 Dec 10;283(24):1297–1301. doi: 10.1056/NEJM197012102832401. [DOI] [PubMed] [Google Scholar]

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