ABSTRACT
The clinical features and investigations relating to gastrointestinal function are presented in 12 cases of juvenile dermatitis herpetiformis seen over a period of 2 years in Jamaica. None of the children had evidence of steatorrhoea. Jejunal biopsy in 10 cases showed normal mucosa in 1, ridging and convolutions in 8 and a flat mucosa in 1. Electronmicroscopical changes are also described. Lactase deficiency malnutrition in infancy or at the time of biopsy. An interesting feature was relapse following iodine contrast media used during jejunal biopsy and a high incidence of iodine in drinking water in some parts of Jamaica. (AU)
Subject(s)
Humans , Infant , Child, Preschool , Child , Male , Female , Dermatitis Herpetiformis , /anatomy & histology , /physiology , Biopsy , Jamaica , Hematologic Tests , /analysis , Disaccharides , Jejunum/anatomy & histology , Microscopy, Electron , Blister/drug therapy , Celiac Disease , Anemia , Intestinal Diseases, Parasitic , Dermatitis Herpetiformis/prevention & control , Iodine/adverse effects , Nutrition Disorders/complications , Lactose IntoleranceABSTRACT
Malabsorption and jejunal abnormalities have been described in some adult patients with dermatitis herpetiformis, but no studies have been made in children. Six children under the age of eleven years with dermatitis heptiformis have been investigated. Serum levels of proteins, folic acid, iron, calcium and phospated were measured. Barium meals, xylose tolerance tests and faecal fat measurements were also done. Peroral jejunal biopsies were performed and examined for disaccharidase levels and histological changes. In all children the haemoglobin was above 10 grams percent: two had eosinophilia: in one case associated with ascaris lumbricoides infestation. Serum levels of calcium, phosphate, and folate were all normal as were faecal fat excretion rates. Three children had abnormal xylose tolerance tests and one a low serum iron while in two children the barium meals were suggestive of malabsorption. All the jejunal biopsies showed villous abnormalities on histological examination, but with the exception of lactase, which in three cases was less than 1 unit per gram of wet weight of mucosa, the disaccharidase levels were normal. It is concluded that these children have jejunal abnormalities often associated with lactase deficiency(AU)