Associated Conditions
Associated Conditions
Are there other diseases related to celiac disease?
What is Dermatitis Herpetiformis?
Can Dermatitis Herpetiformis be misdiagnosed as any other skin condition?
What are some of the symptoms of disease outside the GI tract?
Do I have an increased risk of getting cancer if I have celiac disease?
If a diabetic goes on a gluten-free diet, will their diabetes improve?
Are there other diseases related to celiac disease?
A number of autoimmune diseases are associated with celiac disease. These include:
- Autoimmune thyroid disease
- Dermatitis Herpetiformis (a skin rash, described in detail below)
- Neuromuscular disorders ( can be autoimmune)
- Rheumatoid arthritis
- Autoimmune thyroid disease
- Autoimmune hepatitis
- Biliary autoimmune liver disease (PBC, PSC)
- IgA nephropathy (deposits of IgA antibodies in the kidney)
- Psoriasis (a skin condition that causes scaly patches to develop)
- Insulin-dependent diabetes (Type 1)
- Sjögren's syndrome
- Vitiligo ( a chronic condition that results in the loss of skin pigment)
- Systemic lupus erythematous
- Cerebellar ataxia ( can be autoimmune)
Others diseases include:
- Iron deficiency anemia
- Osteoporosis
- A variety of cancers
- IgA deficiency (a deficiency of the antibody that protects the mucous membranes)
- Microscopic or lymphocytic colitis
- Down's syndrome
- Anxiety
- Depression
- Migraine
What is Dermatitis Herpetiformis?
Dermatitis Herpetiformis (DH) is an itchy skin condition that is associated with celiac disease. The rash most commonly affects the elbows, knees, buttocks, scalp, and back. It usually starts as small bumps that become blisters and then get scratched off. It appears in several areas, and is formed as a result of ingesting gluten. DH is diagnosed by a small skin biopsy done by a dermatologist. The rash usually improves or even disappears on a gluten-free diet, but may not go away completely. There is a medication called Dapsone that will help treat the rash. However, Dapsone is only a temporary remedy for DH, and a gluten-free diet is necessary to treat DH, as well as intestinal damage. Most individuals with DH do not have obvious gastrointestinal symptoms, but almost all have some intestinal damage.
Can Dermatitis Herpetiformis be misdiagnosed as any other skin condition?
Though DH may appear similar to other skin conditions, a biopsy of the lesions would confirm the diagnosis of DH. While the findings of DH are very specific, it is important that the dermatologist is considering this diagnosis so that he/she can take a sample of the correct area and order the correct tests.
What are some of the symptoms of disease outside the GI tract?
Those affected with celiac disease do not always show common gastrointestinal symptoms of the disease, such as diarrhea or abdominal cramping and bloating. In fact, they may experience extra-intestinal symptoms, or problems outside of the intestine, that can involve many of the body's different organs and systems.
Extra-intestinal Symptoms (not all inclusive):
Blood
- Improper absorption of vitamin K (a fat soluble vitamin) can result in bleeding problems
- Anemia due to insufficient absorption of folate and iron in the small intestine, as well as chronic mild blood loss; in severe cases of sprue, a deficiency of B12 can also lead to anemia
Bone
- Osteoporosis / Osteopenia [decrease in the amount of bone tissue] These conditions result from insufficient absorption of calcium and vitamin D by the damaged intestinal villi, as well as due to inflammatory processes directly targeting bone.
- Joint Pain/Bone Pain
Neurologic
- Neurological symptoms include muscle weakness, numbness, and ataxia (poor muscle coordination)
- Seizures may develop with or without cerebral calcifications. This is rare and has only been shown in limited studies.
- Chronic fatigue syndrome (incapacitating tiredness that may last for months, along with sore throat, myalgias, and cognitive dysfunction)
- Anxiety
- Depression
- Dementia
Reproductive and Endocrine System
- Infertility
- Recurrent Abortions
- Hormonal problems that include amenorrhea [lack of a menstrual cycle], delayed menstruation, and infertility in women. Impotence and infertility in men has been seen as well.
Skin
- Skin disorders, including Dermatitis Herpetiformis (see picture) have been seen in celiac patients. See "What is Dermatitis Herpetiformis?" section.
Cancers
- Increased risk of developing several different types of cancer has been seen in patients with celiac disease. These cancers include small bowel lymphoma/enteropathy associated T-cell lymphoma (EATL), small bowel adenocarcinoma, large bowel carcinoma, hodgkins lymphoma, oropharyngeal cancer and primary liver cancers. See "Do I have an increased risk of getting cancer if I have celiac disease?" section.
Do I have an increased risk of getting cancer if I have celiac disease?
If you do not treat your celiac disease, you will have a slightly greater risk of developing certain types of gastrointestinal cancer, as well as non-Hodgkin's lymphoma. However, after remaining on a gluten-free diet for five years, these elevated risks will return to that of the American population.
Individuals with celiac disease will continue to have an increased risk of developing enteropathy-associated T-cell lymphoma (EATL), which is a type of cancer. However, this cancer is extremely rare, even among patients with celiac disease.
If a diabetic goes on a gluten-free diet, will their diabetes improve?
Unfortunately, there is no evidence demonstrating that diabetes will improve on a gluten-free diet; however, it is important for people with celiac disease and diabetes to follow the gluten-free diet like all people with celiac disease. When starting a gluten-free diet you should monitor your sugars carefully, as there are often changes in weight and response to insulin. A dietician skilled in the nutrition needs of both diseases should be consulted.