Case Report Links Gut Disorder to Alopecia Universalis

The autoimmune disorder Alopecia Areata and its related conditions have multiple triggers that initiate their onset. The hair loss that ensues is usually sudden and can be both patchy or much more severe.

Doctors in Mumbai have recently reported that the list of suspected triggers may need to be extended. Now, as well as psychological long-term stress, shock/extreme stress, physical trauma, local skin injury, viral infection and at least four other suspected factors, the Indian doctors say that a serious intestinal disorder named Hirschsprung Disease (HD) may be added to the list.

Rare form of alopecia

They refer to the case of a newborn baby girl who was born prematurely weighing just 1.4kg. At birth, a clinical examination found a total absence of all hair on her scalp and body. This is consistent with a condition known as Alopecia Universalis, which is related to Alopecia Areata but rarer. More precisely, the baby was suspected of having Alopecia Universalis Congenita, an extremely rare form of alopecia that is occasionally seen in new-born babies.

Tests showed that the infant who had been vomiting had HD. A biopsy of skin from her scalp, meanwhile, was suggestive of Alopecia Universalis. Tragically, the baby girl died due to multi-organ failure.

The doctors report that the parents of the baby told them that they had had another child who died a short time after birth; this sibling had both Alopecia Universalis and a congenital defect of the alimentary tract.

The same parents later had a third child which was healthy and showed no signs of Alopecia of any kind.

Summing up, the doctors at the hospital write: “All cases of HD should be thoroughly investigated for associations with syndromes and anomalies. Alopecia is an unusual association with HD. Congenital alopecia usually poses a diagnostic dilemma to the treating physicians and early diagnosis will help in appropriate management of these cases. Genetic evaluation of the affected individuals with HD and Alopecia Universalis is essential for better understanding of the disease.”

Treatable forms of alopecia

Alopecia Areata and its related autoimmune conditions are markedly different from other hair loss conditions and are, perhaps, the least understood. Experts know, for example, that Androgenetic Alopecia, better known as Male Pattern Baldness and Female Pattern Hair Loss  which can be treated with clinically-proven hair loss treatments  happens in people who are genetically predisposed to be sensitive to a testosterone by-product named DHT. This in turn leads to the slow, steady demise of their hair follicles, outwardly displaying as gradually thinning hair.

Alopecia Areata, while also treatable in its milder form (patchy hair loss from the scalp as opposed to total baldness) presents more of a challenge to the medical community, and is perhaps only know on the verge of being more comprehensively understood, thanks in part to the work of scientists such as Dr Angela Christiano and her team at Columbia University in New York.