<<Disclaimer:  Verify this information before applying it to your situation.>>

> Is it possible to have sprue and DH?

Wendy,

DH is a subset or secondary condition to sprue. Or in other words all DH
patients also have sprue. Here's a discussion of DH that was in the log files:

                         THE SPRUE-NIK PRESS

        Published by the Tri-County Celiac Sprue Support Group,
        a chapter of CSA/USA, Inc. serving southeastern Michigan

Eighteenth Edition                                          March 1995
**********************************************************************
[snip...]
                      "Celiac in the 90s"
                      -------------------
                    summarized by Jim Lyles

Dr. Joseph Murray, of the University of Iowa, is a gastroenterologist
that specializes in treating Celiac disease.  He gave a talk entitled
"Celiacs in the 90s" at a conference hosted by the American Celiac
Society on June 10-11, 1994.  What follows are highlights of Dr.
Murray's talk.

[snip...]

Dr. Murray believes that ALL Dermatitis Herpetiformes (DH) patients
also have Celiac disease, whether they realize it or not.  This celiac
disease is often latent or silent.  Earlier reports of patients with
DH who did not have enteropathy (small intestinal damage) may not have
counted milder forms of the celiac disease damage.  (Editor's note:
Dr. Alexander, our physician advisor, believes most, but not all DH
patients have Celiac disease.)

[snip...]

About 5% of CS patients also have DH.  At the University of Iowa,
there have been 350 patients diagnosed with DH.  Dr. Murray believes
these have celiac disease.  If these DH patients are only 5% of the
Celiacs, then there should be about 7,000 Celiacs in the Iowa area.
The number of diagnosed Celiacs is much less than 7,000.  Even if this
extrapolation is exaggerated, it is still clear that there are many
undiagnosed Celiacs out in the general population.

Most DH patients are prescribed Dapsone, which treats the symptoms.
In most cases, they are told of the GF diet, but it is not stressed
and so most DH patients do not follow the diet.  Dr. Murray finds this
most distressing, because even if these patients don't have GI-related
symptoms, there is still continual damage being done to the small
intestine.  Dermatologists, in general, don't give enough
consideration to a GI problem as the source of DH.  This places DH
patients at an even greater risk of developing lymphoma in the small
intestine.

[snip...]

DH is caused by reactions to antibody complexes that, for reasons not
totally clear, become deposited under the skin.  These DH breakouts
can continue for a long time after a GF diet is adopted, because these
deposits are not reabsorbed by the body very quickly.  In about 70% of
the cases, dapsone treatments can be discontinued after 18 months-2
years; for the other 30% it takes longer.

[snip...]