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Dr. Horvath,

I saw your recent note on the use of serological tests in
celiac disease in this mailing list.  I am interested in your
thoughts and input on my situation.

I have just been diagnosed with dermatitis herpetiformes.  My
questions are as follows:

(1) Should I see my GI for diagnosis as to celiac?  I have no
symptoms of celiac, so far as I know (i.e., no stomach problems
of any kind).

(2) If I do set up an appointment with my GI, what diagnostic
tests should I expect if he is competent to diagnose this
rather rare disease?

(3) If celiac is diagnosed, what is the treatment?  I assume
that it is a gluten free diet, which is the recommended
treatment for DH (along with dapsone therapy).  If I simply go
on a gluten free diet but do not go through the diagnostic
procedures to confirm celiac, what additional risks am I
running?

(4) If I do not have the specific diagnostic tests for celiac
and continue on a gluten free diet, what symptoms could arise
which would lead me to conclude that I may have celiac disease
requiring some treatment other than the GF diet?

(5) If I elect to, or cannot, stay on the gluten free diet,
what is the risk assuming that I do have celiac disease?  I
have seen the literature reflecting an increased risk of cancer
(6-8% are the figures that I have seen), but what other
risks/problems occur with celiac disease?

Thank you very much for any help in answering these questions
for me.

Regards,

Paul

--
Paul Sinclair
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Richmond, Virginia