A patient with systemic lupus erythematosus (SLE) may develop celiac disease. The occurrence of celiac disease in higher in patients with SLE compared to matched controls.
Clinical features:
(1) usually the onset of SLE precedes that of celiac disease
(2) villous blunting on small bowel biopsy
(3) the celiac disease responds to gluten-free diet
(4) variable dermatitis herpetiformis
Certain histocompatibility antigens (HLA-B8, HLA-DR3) are found more commonly in both conditions.
Differential diagnosis:
(1) lupus enteritis
(2) adverse drug effects
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