I am very happy to announce that a case report I wrote as part of the Masters of Science program at the National University of Health Sciences, submitted in November 2010 and accepted in June 2011, has gone into publication in the peer-reviewed Journal of Chiropractic Medicine. The subject was considered very timely and interesting by the peer reviewers.
The case highlights the difficulty surrounding the accurate diagnosis of Celiac Disease (CD). There are several forms of the disease, which present very differently in the clinical setting. Formerly referred to as Celiac Sprue, CD has been typically associated with irritable bowel type symptoms: bloating, weight loss and malabsorption. Patients with atypical or extra-intestinal CD primarily present with symptoms not associated with any digestive disorders, such as severe itching and eczema (also known as Dermatitis Herpetiformis, particularly in association with CD) and severe heartburn. Other associated symptoms that seem unrelated to a gluten-sensitivity are infertility, thyroid disorders, anemia, depression, fatigue, osteoporosis, liver and neurological diseases. It has been recently suggested that physicians need to consider CD behind many different clinical syndromes, not just those that exhibit digestive symptoms.
The tests routinely done to rule out CD are not always accurate. A small bowel biopsy is not always positive, and antibody tests – considered the “gold standard” tests for CD – can be negative. The only test to conclusively rule out CD is a DNA test.
This case also highlights that acupuncture was very effective in alleviating the symptoms which this patient experienced long before CD was accurately diagnosed. Traditional Chinese Medicine (TCM) treats the signs the patient exhibits and the symptoms they describe, and a western medicine diagnosis is not necessary to begin treatment. Furthermore, TCM diagnostics accurately identified a digestive system disorder as the root of the eczema.
The title of the article is “Acupuncture and a gluten-free diet relieve urticaria and eczema in a case of undiagnosed dermatitis herpetiformis and atypical or extraintestinal celiac disease: a case report.”
If you are interested in a copy of the article, kindly send me your address, and I will send you a copy.
Reprints are available from the Journal of Chiropractic Medicine December 2011 Volume 10, Issue 4, pages 294-300.