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Lymphoma in patients with dermatitis herpetiformis and their first‐degree relatives
Author(s) -
Hervonen K.,
Vornanen M.,
Kautiainen H.,
Collin P.,
Reunala T.
Publication year - 2005
Publication title -
british journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.304
H-Index - 179
eISSN - 1365-2133
pISSN - 0007-0963
DOI - 10.1111/j.1365-2133.2005.06345.x
Subject(s) - lymphoma , dermatitis herpetiformis , medicine , gastroenterology , enteropathy , coeliac disease , first degree relatives , disease , gluten free , family history
Summary Background The risk for lymphoma is increased in both dermatitis herpetiformis (DH) and in coeliac disease. The lymphoma most associated with coeliac disease is enteropathy‐associated T‐cell lymphoma. Objectives To study the occurrence and type of lymphoma in a large series of patients with DH and their first‐degree relatives. Methods The occurrence of lymphoma was studied in 1104 patients consecutively diagnosed with DH in two university hospitals during 1969–2001. A questionnaire was sent to 341 patients to examine the occurrence of lymphoma in their 1825 first‐degree relatives. To analyse whether the DH patients with lymphoma had adhered to a gluten‐free diet similarly to the patients without lymphoma, two age‐ and sex‐matched patients with DH served as controls for each index case. Data on the gluten‐free diet were collected from prospectively completed dietary forms and also from medical records. Results Eleven (1%) patients contracted lymphoma 2–31 years after the diagnosis of DH. Eight had B‐cell‐type lymphoma, two enteropathy‐associated T‐cell lymphoma and one remained unclassified due to missing material. Three (0·2%) of the first‐degree relatives contracted lymphoma, all B‐cell type. The 11 DH patients with lymphoma had adhered to a gluten‐free diet significantly less strictly than the DH controls without lymphoma. Conclusions The present study documents that patients with DH can have both B‐ and T‐cell lymphoma. The DH patients with lymphoma had not adhered as strictly to the gluten‐free diet as the control patients without lymphoma. The occurrence of lymphoma in the first‐degree relatives was lower than in the patients with DH.