ABSENCE OF TOXICITY OF OATS IN PATIENTS WITH DERMATITIS-HERPETIFORMIS

Background People with gluten sensitivity should avoid foods containin g wheat, rye, and barley, but there has been debate about whether they should avoid oats. Although patients with celiac disease have recentl y been shown to tolerate oats, less is known about the effects oi oats on patients with dermatitis herpetiformis. Methods We studied seven m en and three women (mean age, 58 years) with biopsy-confirmed dermatit is herpetiformis. They had followed a strict gluten-free diet for a me an of 15.8 years, which controlled their rash and enteropathy. The pat ients added oats that were not contaminated with gluten to their diets for 12 weeks (mean [+/-SD] daily intake, 62.5+/-10.8 g). Results None of the patients had any adverse effects. Serologic tests for antiglia din, antireticulin, and antiendomysial antibodies were negative before oats were introduced into the diet and after they were discontinued. Villous architecture remained normal: the mean (+/-SE) ratio of the he ight of vilii to the depth of crypts was 3.59+/-0.11 before the diet a nd 3.71+/-0.09 afterward (normal, 3 to 5), and the mean enterocyte hei ghts were 31.36+/-0.58 mu m and 31.75+/-44 mu m, respectively (normal range, 29 to 34), Duodenal intraepithelial lymphocyte counts all remai ned within normal limits (mean, 13.8+/-1.03 per 100 enterocytes before the diet and 14.2+/-1.2 per 100 enterocytes afterward; normal range, 10 to 30). Dermal IgA showed no significant changes. Conclusions Patie nts with dermatitis herpetiformis can include moderate amounts of oats in their gluten-free diets without deleterious effects to the skin or intestine. (C) 1997, Massachusetts Medical Society.