Gastrointestinal investigations in dermatitis herpetiformis

Thirty-seven patients with dermatitis herpetiformis (DH) have been investigated for gastric and small intestinal abnormalities. Evidence of an enteropathy was found in 86% of the patients who had IgA deposits in uninvolved skin. Villous atrophy of the small intestine was found in 29 patients. About one-half of the patients had reduced absorption of xylose and vitamin A. The Schilling test value was lowered in one-third. Serum B12 was too low in 5/28 patients whereas folic acid in serum and whole blood was too low in 14/29 and 5/19, respectively. Atrophic gastritis occurred in 14/28 patients and only about one-third of the whole patient material had normal gastric mucosal structure and secretion.