Chapter 61 DH

Question 1

age in DH

Answer 1

any age including childhood, most common 2nd 3rd and 4th decades

Question 2

intestinal abnormality in ___%

Answer 2

60-75%

Question 3

gluten found in ___

Answer 3

wheat
barley
rye
(oats -devoid of toxicity)

Question 4

in small bowels of DH patients, there is increased density of

Answer 4

intraepithelial T celss w/ y/d T cell receptor in jejunum

Question 5

DH on regular gluten containing diet have increased ____

Answer 5

IL2 receptor and serum IL8 levels, E selectin on skin and CD11b on neutrophils

Question 6

dominant autoantigen in DH

Answer 6

epidermal Tgase

Question 7

_____, administered orally can exacerbate DH

Answer 7

iodides

Question 8

few case reports of DH with medications ____

Answer 8

Interferon
ribavirin
gonadotropin releasing hormone

Question 9

primary lesion

Answer 9

erythematous papule, urticaria like plaque or most commonly vesicle

Question 10

stinging, burning, itching may precede lesions ____hours prior

Answer 10

8-12 hrs

Question 11

most reliable criterion for diagnosis?

Answer 11

granular IgA

Question 12

predominant subclass in DH

Answer 12

IgA1

Question 13

C3 affected by dapsone. T/F?

Answer 13

false

C3 may not be detectable after treating w/ gluten free diet

Question 14

Serum studies showed

Answer 14

antireticulin antibodies of IgG and IgA
thyroid microsomal antibodies and ANA
IgA antibody binds to intermyofibril substance (endomysium of smooth muscle)

Question 15

Tgase antibodies should not be considered as diagnostic test. T/F?

Answer 15

true

Question 16

All with DH have genes that encode

Answer 16

HLA-DQ (a10501,B102)

HLA-DQ (a103,B10302)

Question 17

1st degree _____ of DH and GSE often affected

Answer 17

relatives

Question 18

blister forms _____

Answer 18

above lamina densa within lamina lucida

Question 19

in DH one observes

____, _____, _____

Answer 19

steatorrhea
abN d-xylose absorption
anemia sec to iron or folate deficiency

Question 20

increased incidence of

_____ and ____

Answer 20

achlorydia

atrophic gastritis

Question 21

increased frequency of malignancies such as?

Answer 21

GI lymphomas

NHL

Question 22

higher incidence of autoimmune disease such as?

Answer 22

thyroid disease
insulin dependent DM
LE
Sjogren
vitiligo

Question 23

untreated celiac disease have increased frequency of

Answer 23

bone loss

Question 24

differential dx

Answer 24

BP
PG
linear IgA
atopic dermatitis
papular urticaria

Question 25

Treatment?

Answer 25

dapsone
sulfoxone
sulfapyridine

Symptoms may abate in 3 hrs or few days
new lesions no longer erupt after 1-2 days

Question 26

dose of dapsone

Answer 26

100-150mg

Question 27

drugs that can exacerbate DH

Answer 27

NSAIDs

Question 28

duration to reduce or completely eliminate need for medication when treating with gluten free diet (effect on skin)

Answer 28

5mos - 1 yr

Question 29

beneficial in alleviating skin disease

Answer 29

free amino acids
short chain polysaccharides
triglycerides

***atkins diet