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Self-Reported Fractures in Dermatitis Herpetiformis Compared to Coeliac Disease

Pasternack, Camilla, Mansikka, Eriika, Kaukinen, Katri, Hervonen, Kaisa, Reunala, Timo, Collin, Pekka, Huhtala, Heini, Mattila, Ville M., Salmi, Teea
Nutrients 2018 v.10 no.3
bone fractures, celiac disease, dermatitis, drug therapy, females, gastrointestinal system, patients, proton pump, proton pump inhibitors, questionnaires
Dermatitis herpetiformis (DH) is a cutaneous manifestation of coeliac disease. Increased bone fracture risk is known to associate with coeliac disease, but this has been only scantly studied in DH. In this study, self-reported fractures and fracture-associated factors in DH were investigated and compared to coeliac disease. Altogether, 222 DH patients and 129 coeliac disease-suffering controls were enrolled in this study. The Disease Related Questionnaire and the Gastrointestinal Symptom Rating Scale and Psychological General Well-Being questionnaires were mailed to participants; 45 out of 222 (20%) DH patients and 35 out of 129 (27%) of the coeliac disease controls had experienced at least one fracture (p = 0.140). The cumulative lifetime fracture incidence did not differ between DH and coeliac disease patients, but the cumulative incidence of fractures after diagnosis was statistically significantly higher in females with coeliac disease compared to females with DH. The DH patients and the coeliac disease controls with fractures reported more severe reflux symptoms compared to those without, and they also more frequently used proton-pump inhibitor medication. To conclude, the self-reported lifetime bone fracture risk is equal for DH and coeliac disease. After diagnosis, females with coeliac disease have a higher fracture risk than females with DH.