Celiac disease

Abstract

Celiac disease, with a prevalence around 1% of the general population, is the most common genetically‐induced food intolerance in the world. Triggered by the ingestion of gluten in genetically predisposed individuals, this enteropathy may appear at any age, and is characterized by a wide variety of clinical signs and symptoms. Among them, gastrointestinal presentations include chronic diarrhea, abdominal pain, weight loss or failure to thrive in children; but extra‐intestinal manifestations are also common, and actually appear to be on the rise. They include a large variety of ailments, such as dermatitis Herpetiformis, anemia, short stature, osteoporosis, arthritis, neurologic problems, unexplained elevation of transaminases, and even female infertility. For the clinician interested in oral diseases, celiac disease can lead to delayed tooth eruption, dental enamel hypoplasia, recurrent oral aphthae. Diagnosing celiac disease requires therefore a high degree of suspicion followed by a very sensitive screening test: serum levels of the autoantibody anti‐tissue transglutaminase. A positive subject will then be confirmed by an intestinal biopsy, and will then be put on a strict gluten‐free diet, that in most cases will bring a marked improvement of symptoms. Newer forms of treatment which in the future will probably be available to the non‐responsive patients are currently being actively pursued.

Celiac Disease and Its Impact on the Oral Health Status – Review of the Literature

“…Among these autoantibodies, the following are routinely studied: anti-TTG IgA/IgG antibodies, anti-endomysial antibodies IgA/IgG (EMA), and recently introduced antibodies against deaminated gliadin peptides DGP-IgG. The result of these processes is an inflammatory state within the intestinal wall, damage to the intestinal villi, and absorption impairment with a progressing malnutrition and related consequences [3].…”

“…The risk of celiac disease increases in diabetes mellitus type 1, Down syndrome, Williams syndrome, IgA deficiency, autoimmune thyroiditis, as well as in close relatives of a patient with celiac disease [2,3]. In the case of the presence of one of the diseases listed above, serologic screening tests should be performed, and if they are positive, further diagnostics should be performed according to the required standards.…”

“…The amount of gluten, and kind of gluten included in the diet seems to be equally important. Long-lasting infections in early childhood, as well as improper composition of intestinal flora are also taken into consideration as the factors participating in the ethiopathogenesis of the disease [3].…”

The Effect of Celiac Disease on the Oral Cavity: A Review )

“…The current dietetic recommendations advise that gluten should be gradually introduced in the diet between 4 and 6 months of age, with careful observation for undesired reactions. Late introduction of gluten may result in atypical Celiac disease, with delayed diagnosis or undiagnosed disease for several years [11]. Alterations in the oral cavity are frequently observed in patients with Celiac disease and may allow for early diagnosis and treatment.…”

“…Approximately 83% patients remain undiagnosed or are misdiagnosed, which can result in irreversible medical and dental complications [10]. Celiac disease is a multifactorial disorder, with both genetic and environmental factors playing a role in the etiology [11]. Genetically close relatives of a patient with celiac disease are at significant risk of developing the disorder (5%-15%) [12].…”