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Case Reports
. 2006 Jun;20(6):433-5.
doi: 10.1155/2006/574074.

Dermatomyositis associated with celiac disease: response to a gluten-free diet

Min Soo Song  1 , David Farber, Alain Bitton, Jeremy Jass, Michael Singer, George Karpati
Affiliations
Case Reports

Dermatomyositis associated with celiac disease: response to a gluten-free diet

Min Soo Song et al. Can J Gastroenterol. 2006 Jun.

Abstract
in English, French

The association between dermatomyositis and celiac disease in children has been well documented. In the adult population, however, the association has not been clearly established. A rare case of concomitant dermatomyositis and celiac disease in a 40-year-old woman is presented. After having been diagnosed with dermatomyositis and iron deficiency anemia, this patient was referred to the gastroenterology clinic to exclude a gastrointestinal malignancy. Blood tests revealed various vitamin deficiencies consistent with malabsorption. The results of gastroscopy with duodenal biopsy were consistent with celiac disease. After she was put on a strict gluten-free diet, both nutritional deficiencies and the dermatomyositis resolved. The patient's human leukocyte antigen haplotype study was positive for DR3 and DQ2, which have been shown to be associated with both juvenile dermatomyositis and celiac disease. It is suggested that patients with newly diagnosed dermatomyositis be investigated for concomitant celiac disease even in the absence of gastrointestinal symptoms.

L’association entre la dermatomyosite et la maladie cœliaque est bien documentée chez les enfants. Au sein de la population adulte, cependant, cette association n’est pas clairement établie. Un rare cas de dermatomyosite concomitante à une maladie cœliaque est présenté chez une femme de 40 ans. Après un diagnostic de dermatomyosite et d’anémie ferriprive, la patiente a été aiguillée vers une clinique de gastroentérologie pour exclure le risque de malignité gastro-intestinale. Les analyses sanguines ont révélé diverses carences vitaminiques compatibles avec une malabsorption. Les résultats de la gastroscopie avec biopsie duodénale suggéraient une maladie cœliaque. Après avoir entrepris un régime sans gluten strict, tant les carences nutritionnelles que la dermatomyosite ont disparu. L’étude d’haplotypes HLA était positive au DR3 et au DQ2, dont l’association avec la dermatomyosite juvénile et la maladie cœliaque est démontrée. On suggère que les patients atteints d’une dermatomyosite nouvellement diagnostiquée fassent l’objet d’explorations pour déceler une maladie cœliaque concomitante, même en l’absence de symptômes gastro-intestinaux.

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