Alopecia Areata

Melinda Dennis MS, RDN, LDN
Q: Is there any relation between alopecia areata (AA) and celiac disease? Is it one of the symptoms of celiac disease, or is it affected by celiac disease?

Answer


“Alopecia areata (AA) is a common autoimmune disease that causes hair loss on the scalp, face, and sometimes other body areas and can recur and regress unpredictably.”1

A clear association between AA and celiac disease was first noted in a 1995. Researchers observed a higher frequency of celiac disease in those with AA than can be expected by chance and they suggested checking celiac antibodies in those patients with AA.2

Researchers in a 2014 study of 12 children with AA found five (41.7%) had positive anti-tissue transglutaminase IgA (TTG-IgA). On biopsy, all five were diagnosed with celiac disease. According to the researchers, silent celiac disease appears to be very high among children with AA, may be the only clinical manifestation, and like the previous researchers suggested, should be tested for in children with AA.3

Over the years, there have been many reports of an association between celiac disease and skin disorders that improve on the gluten-free diet. Dermatititis Herpetiformis is the best known. Rodrigo and team emphasized the importance of gastroenterologists and dermatologists working closely together because of the growing link between skin diseases and CD. They also recommend actively searching for non-typical symptoms (outside of the GI tract) to screen for celiac disease.4

References

1.Kaplan L, Castelo-Soccio. When your patient’s parent asks: “my child’ alopecia areata is not getting better. Should he or she get tested for celiac disease?” Pediatric Dermatology.2018;35:535-538.
https://www.ncbi.nlm.nih.gov/pubmed/29797748

2.Corazza GR, et al. Celiac disease and alopecia areata: report of a new association. Gastroenterology. 1995 Oct;109(4):1333-7.

3.Vildan E, Mahya Sultan T, Erdem T. Screening of celiac disease in children with alopecia areata. Indian J Dermatol. 2014 May-Jun; 59(3): 317.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4037977/

4.Rodrigo L, et al. Cutaneous and mucosal manifestations associated with celiac disease. Nutrients 2018, 10(7), 800. https://www.ncbi.nlm.nih.gov/pubmed/29933630

Note: This information is provided by NCA and Melinda Dennis, NCA's Senior Consulting Dietitian. This information is meant for educational purposes and is not intended to substitute for personalized medical advice or replace any medical advice provided directly to you by your health care provider. This information can be printed and used in consultation with your physician or dietitian. No liability is assumed by NCA, Ms. Dennis or her nutrition consulting service Delete the Wheat, LLC. by providing this information..

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About Melinda Dennis MS, RDN, LDN

Melinda Dennis, Senior Nutrition Consultant for NCA, is an expert celiac dietitian and and Nutrition Coordinator for the Celiac Center at Beth Israel Deaconess Medical Center in Boston, MA. Diagnosed with celiac disease in 1990, she specializes in the nutritional treatment of patients with celiac disease and gluten-related disorders.

Melinda lectures internationally and has written extensively on the nutritional management of celiac disease including the award-winning book Real Life with Celiac Disease. Melinda was the original founder of NCA in 1993 and so it is only fitting that she comes back to us in this capacity. We are truly honored to have her on our team.