Corazza G R, Andreani M L, Venturo N, Bernardi M, Tosti A, Gasbarrini G
Department of Internal Medicine, University of L'Aquila, Italy.
Gastroenterology. 1995 Oct;109(4):1333-7. doi: 10.1016/0016-5085(95)90597-9.
Celiac disease is frequently associated with other autoimmune disorders but has never been reported in association with alopecia areata. In a routine clinical practice, 3 patients with such an association were observed. In one of the patients, celiac disease was diagnosed after the occurrence of malabsorption symptoms. In the youngest patient, a 14-year-old boy, gluten-free diet resulted in complete regrowth of scalp and body hair. A prospective screening program for celiac disease using antigliadin and antiendomysial antibodies was therefore set up in 256 consecutive outpatients with alopecia areata. Three patients, all completely asymptomatic for intestinal diseases, were found to be positive and underwent biopsy. Histological analysis showed a flat intestinal mucosa consistent with the diagnosis of celiac disease. The results show that alopecia areata may constitute the only clinical manifestation of celiac disease and that the association between these two conditions is a real one because the observed frequency of association is much greater than can be expected by chance. It is suggested that antigliadin and antiendomysial antibodies should be included in the work-up of patients with alopecia areata.
乳糜泻常与其他自身免疫性疾病相关，但从未有与斑秃相关的报道。在常规临床实践中，观察到3例有这种关联的患者。其中1例患者在出现吸收不良症状后被诊断为乳糜泻。最年轻的患者是一名14岁男孩，无麸质饮食使头皮和身体毛发完全重新生长。因此，对256例连续的斑秃门诊患者开展了一项使用抗麦醇溶蛋白和抗肌内膜抗体进行乳糜泻的前瞻性筛查项目。3例患者均无肠道疾病的任何症状，检测呈阳性并接受了活检。组织学分析显示肠黏膜扁平，符合乳糜泻的诊断。结果表明，斑秃可能是乳糜泻的唯一临床表现，而且这两种病症之间的关联是确实存在的，因为观察到的关联频率远高于偶然预期。建议在斑秃患者的检查中应包括抗麦醇溶蛋白和抗肌内膜抗体检测。
