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Celiac disease of the joint
Ozden Ozyemisci-Taskiran1, Mustafa Cengiz, Fatma Atalay
1Department of Physical Medicine and Rehabilitation, Gazi University Faculty of Medicine, Ankara, Turkey. ozdenozyemisci@yahoo.com
Rheumatology International
|December 15, 2010
Summary
Dermatitis herpetiformis, an autoimmune skin condition, can be associated with joint pain. A gluten-free diet significantly improved knee pain and swelling in a patient with this condition.
Area of Science:
- Rheumatology
- Dermatology
- Immunology
Background:
- Dermatitis herpetiformis (DH) is a chronic autoimmune blistering skin disease.
- DH is strongly associated with celiac disease, involving gluten sensitivity.
- Joint involvement in DH is recognized but often underdiagnosed.
Observation:
- A 42-year-old woman with a 12-year history of biopsy-proven dermatitis herpetiformis presented with severe left knee pain and swelling.
- Her symptoms significantly limited mobility, requiring wheelchair dependence.
- She had no prior history of a gluten-free diet.
Findings:
- Treatment with a gluten-free diet led to a significant improvement in knee pain and swelling.
- The patient's mobility and antalgic gait resolved with dietary changes.
- This case suggests a potential immunopathogenic link between DH and arthritis.
Implications:
- A gluten-free diet may be a crucial therapeutic intervention for joint manifestations in patients with dermatitis herpetiformis.
- Further research into the immunopathogenesis of DH-associated arthritis is warranted.
- Clinicians should consider screening for joint involvement in patients with DH and vice versa.
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