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Hepatic injury in dermatitis herpetiformis.

Liver function tests were performed in 60 patients with dermatitis herpetiformis. Abnormalities of bilirubin or elevated liver enzyme levels were found in 17% of the patients. 13% had abnormal liver enzymes or elevated bilirubin levels not due to haemolysis. In 8% of patients bilirubin levels were elevated as a result of dapsone-induced haemolysis. The incidence of liver function abnormalities was higher (19%) in those on a normal diet than those on a gluten-free diet (9%). The abnormalities were not associated with the presence of immune complexes, anti-mitochondrial or anti-smooth muscle antibodies.