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Two recent articles of interest have come out.  I am skeptical of the
usefulness of the study of allergy prevalence in adult celiacs which relies
on questionaires and the patients ability to recognize symptoms that might
be the result of allergic sensitivities to various foods.  The study only
considers individuals who reported in questionnaires they experienced
allergy symptoms .

In my own case, it took me months after going gluten-free to finally
associate various symptoms of fatigue, general malaise, and alterations of
bowel movements with various newly acquired food sensitivities.  Very large
doses of vitamin C, as an antihistamine, gave me temporary relief from
bowel conditions and confirmed that my discomfort was the result of
allergic responses that released histamine.  Some foods began to cause
irritated throat, throat clearing, and sniffles with 20 minutes after
consumption.  Identifying and eliminating problem foods helped,
temporarily.  The problem worsened as I become sensitive to more and more
foods.  It wasn't until I began to take digestive enzymes and betaine HCl
to treat low stomach acid that I was able to control and significantly
reduce or eliminate most of the food sensitivities.

Low stomach acid (hypochlorhydria), intestinal permeability (leaky gut),
and alterations in the mix of intestinal flora all appear to be common in
celiac disease.  These conditions can all result in the acquisition of food
allergies.  Postings on this Celiac List, seem to confirm that food
allergies are a very common problem among celiacs.  People need to be
educated and able to carefully observe and corollate their various symptoms
and discomforts to allergic responses to foods.  I don't believe a study of
this type that selects its subjects on the basis of a questionnaire is very
useful.  A gluten-free diet alone, obviously did not reduce my allergic
symptoms.  So the article's conclusion that a one year gluten-free
diet "did not change allergy prevalence" is probably valid.  The article,
however, fails to address the above-mentioned conditions as a cause of
allergy in celiacs.

The second article serves as a warning to those who may be experiencing
neurological symptoms, to make sure they are absorbing sufficient amounts
of vitamin E.

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J Allergy Clin Immunol. 2004 Jun;113(6):1199-1203

Allergy prevalence in adult celiac disease.

Ciacci C, Cavallaro R, Iovino P, Sabbatini F, Palumbo A, Amoruso D, Tortora
R, Mazzacca G.

Gastrointestinal Unit, Federico II University of Naples Italy.

BACKGROUND: Celiac disease is considered to arise from an inappropriate T-
cell-mediated immune response against ingested gluten in genetically
predisposed people, whereas the T(H)2-type lymphocytes are mostly involved
in IgE-mediated reactions. The matter of possible coexistence of T(H)1- and
T(H)2-type diseases is still debated. OBJECTIVE: This study was aimed to
evaluate the allergy prevalence in a large series of adults with untreated
celiac disease and their families at the moment of diagnosis. We also
evaluated whether 1 year of gluten-free diet had any effect on allergy
prevalence in our cohort. METHODS: At the moment of celiac disease
diagnosis a standardized questionnaire was administered for detailed
information on presence and type of any allergy symptoms in 1044 adult
patients with celiac disease, 2752 relatives, and 318 spouses. Those
reporting any allergy underwent tests with dosage of serum levels of total
IgE and search for serum specific IgE with a standard makeup of 20 antigens
and PRICK tests in selected individuals. At follow-up visit patients with
celiac disease were administered the same allergy questionnaire. RESULTS:
One hundred seventy-three patients with celiac disease (16.6%), 523
relative (19%), and 43 spouses (13.5%) had at least 1 allergy (P=not
significant). Atopic dermatitis was more frequent in patients with celiac
disease (3.8%) and their relatives (2.3%) than in spouses (1.3%). The
presence of allergy in general and atopic dermatitis was not affected by
presence of overt malabsorption or duration of undiagnosed disease. Follow-
up data showed no change in allergy prevalence in the cohort examined.
CONCLUSION: Allergy prevalence in a large series of patients with celiac
disease is not different from that of their relatives and spouses. However,
atopic dermatitis was about 3 times more frequent in patients with celiac
disease and 2 times more frequent in their relatives than in spouses. One
year of gluten-free diet did not change allergy prevalence in the celiac
group under investigation.

PMID: 15208605 [PubMed - as supplied by publisher]

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Clin Immunol. 2004 Jul;112(1):24-29.

Vitamin E deficiency induced neurological disease in common variable
immunodeficiency: two cases and a review of the literature of vitamin E
deficiency.

Aslam A, Misbah SA, Talbot K, Chapel H.

Department of Immunology, Oxford Radcliffe Hospitals, John Radcliffe
Campus, Headington, Oxford OX3 9DU, UK.

Vitamin E deficiency causes a neurological disorder characterised by
sensory loss, ataxia and retinitis pigmentosa due to free radical mediated
neuronal damage. Symptomatic vitamin E deficiency has been reported in
genetic defects of the vitamin E transport protein and in malabsorption
complicating cholestasis, abetalipoproteinaemia, celiac disease, cystic
fibrosis and small bowel resection. There are no reports to date of vitamin
E deficiency in patients with primary immunodeficiencies. We describe two
CVID patients with the associated enteropathy who developed neurological
disease because of vitamin E deficiency, suggesting a possible
predisposition to developing this complication. We recommend that all CVID
patients with evidence of an enteropathy be screened for vitamin E
deficiency, as early detection and consequent treatment may prevent, halt
or reverse the neurological sequelae.

PMID: 15207778 [PubMed - as supplied by publisher]

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