Case report Cutaneous vasculitis complicating coeliac disease

SUMMARY A 38 year old female, with chronic uncontrolled coeliac disease, presented with the rare complication of cutaneous leucocytoclastic vasculitis. Detailed study failed to identify any cause for the vasculitis, other than the underlying coeliac disease. Haematuria and proteinuria with mesangial nephritis were also demonstrated on renal biopsy with electron microscopic study. It is speculated that exogenous or endogenous antigens permeated the abnormal small bowel mucosa leading to formation of circulating immune complexes. Subsequent tissue deposition of these complexes then resulted in vasculitis and nephritis. The skin lesions cleared completely after treatment with a strict gluten free diet. Coeliac disease may give rise to a variety of derma-tological manifestations. ' Cutaneous vascular inflam-mation has been noted in some cases associated with cryoglobulinaemia.25 We report in detail the occur-rence of leucocytoclastic vasculitis in a patient with established, poorly controlled coeliac disease. Case repor