Clinical importance of celiac disease in patients with recurrent aphthous stomatitis

Yaşar, Şirin; Yaşar, Bülent; Abut, Evren; Serdar, Zehra Aşiran

doi:10.4318/tjg.2012.0387

Cited by 16 publications

(20 citation statements)

References 23 publications

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“…In 2012 Yaşar et al studied the prevalence of RAS in a cohort of 82 patients in Istanbul and identified the patients affected by RAS before esophagogastroduodenoscopy. Their results showed that the prevalence of CD in the RAS population did not significantly differ from that of the unaffected matched population [26]. In the same year El-Hodhod et al performed a similar study, evaluating 140 Egyptian patients with DED, aged 4–12, while the control group was represented by 720 healthy children.…”

Section: Discussionmentioning

confidence: 99%

Oral Signs and HLA-DQB1*02 Haplotypes in the Celiac Paediatric Patient: A Preliminary Study

Erriu

Abbate

Pili

et al. 2013

Autoimmune Diseases

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Celiac disease (CD) diagnosis can be extremely challenging in the case of atypical patterns. In this context, oral signs seem to play a decisive role in arousing suspicion of these forms of the disease. At the same time, the different expressions of the HLA-DQB1∗02 allele apparently seem to facilitate the interpretation of signs and highlighted symptoms. The aim of this work was to verify whether it is possible to identify a correlation between the development of oral signs and different DQ2 haplotypes in celiac pediatric patients. 44 celiac patients with a medium age of 9.9 were studied. Oral examinations were performed in order to identify recurrent aphthous stomatitis (RAS) and dental enamel defects (DED). The diagnosis of DED resulted as being related to allele expression (P value = 0.042) while it was impossible to find a similar correlation with RAS. When both oral signs were considered, there was an increase in correlation with HLA-DQB1∗02 expression (P value = 0.018). The obtained results identified both the fundamental role that dentists can play in early diagnosis of CD, as well as the possible role of HLA haplotype analysis in arousing suspicion of atypical forms of the disease.

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Section: Discussionmentioning

confidence: 99%

Oral Signs and HLA-DQB1*02 Haplotypes in the Celiac Paediatric Patient: A Preliminary Study

Erriu

Abbate

Pili

et al. 2013

Autoimmune Diseases

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“…Eight patients with RAS were excluded from study. Five of them filled out the questionnaires incompletely, and three patients had a systematic diseases related to RAS . Fourteen patients with OLP were excluded from the study.…”

Section: Methodsmentioning

confidence: 99%

“…There are many predisposing factors for the occurrence of RAS. Etiological factors can be divided into local factors such as mechanical trauma and systemic factors such as hematological deficits, gastrointestinal diseases, immunodeficiency states (reduced number of T cells), genetic predisposition, hypersensitivity to benzoic acid in food, certain syndromes as Behçet's disease, MAGIC syndrome, PFAPA syndrome, and Sweet syndrome . Very important etiological factors are mental disorders such as stress, depression, and anxiety .…”

Section: Introductionmentioning

confidence: 99%

The role of anxiety, depression, and psychological stress on the clinical status of recurrent aphthous stomatitis and oral lichen planus

Gavić

Cigić

Lukenda

et al. 2014

J Oral Pathology Medicine

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“…The association between CD and RAS has been evaluated in different studies with controversial results. While some studies have reported an increased prevalence of CD in up to 31% of patients with RAS, others have failed to find this association [43]. The clinical response of RAS to a GFD in CD patients has been demonstrated in many different studies [43].…”

Section: Mucocutaneous Manifestations Of CDmentioning

confidence: 99%

Extraintestinal Manifestations of Celiac Disease

Pinto-Sanchez¹,

Berčík²,

Verdú³

et al. 2015

Dig Dis

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Case finding for celiac disease (CD) is becoming increasingly common practice and is conducted in a wide range of clinical situations ranging from the presence of gastrointestinal symptoms to failure to thrive in children, prolonged fatigue, unexpected weight loss and anemia. Case finding is also performed in associated conditions, such as autoimmune thyroid disease, dermatitis herpetiformis and type 1 diabetes, as well as in patients with irritable bowel syndrome, unexplained neuropsychiatric disorders and first-degree relatives of patients with diagnosed CD. This aggressive active case finding has dramatically changed the clinical characteristics of newly diagnosed patients. For instance, higher numbers of patients who present with extraintestinal symptoms are now being diagnosed with CD. Current recommendations state that due to a high risk for complications if the disease remains undiagnosed, patients with extraintestinal symptoms due to CD require appropriate diagnosis and treatment. Despite criticism regarding the cost-effectiveness of case finding in CD, such an aggressive approach has been considered cost-effective for high-risk patients. The diagnosis of CD among patients with extraintestinal symptoms requires a high degree of awareness of the clinical conditions that carry a high risk for underlying CD. Also, understanding the correct use of specific serology and duodenal histology is key for an appropriate diagnostic approach. Both procedures combined are able to confirm diagnosis in the vast majority of cases. However, in certain circumstances, serology and even duodenal histology cannot confirm or rule out CD. A common cause of negative IgA serology is IgA deficiency. For such eventuality, IgG-based serological tests can help confirm the diagnosis. Importantly, some histologically diagnosed cases still remain seronegative despite exclusion of IgA deficiency. On the other hand, duodenal histology may be normal despite the presence of CD-specific antibodies and active CD. This has been clearly demonstrated in some cases of untreated dermatitis herpetiformis, but may also be due to the patchy condition of CD or lesions that are not adequately recognized by nonexpert endoscopists and/or pathologists. The effectiveness of agluten-free diet depends on the clinical end point addressed. A good example is the outcome of bone loss. While risk for fracture normalizes after the first year of dietary treatment, bone parameters measured by densitometry may not be normalized in the long-term follow-up. Moreover, it is still unclear how far an early gluten-free diet will positively affect associated autoimmune diseases like type 1 diabetes and autoimmune thyroiditis.

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Clinical importance of celiac disease in patients with recurrent aphthous stomatitis

Cited by 16 publications

References 23 publications

Oral Signs and HLA-DQB1*02 Haplotypes in the Celiac Paediatric Patient: A Preliminary Study

Oral Signs and HLA-DQB1*02 Haplotypes in the Celiac Paediatric Patient: A Preliminary Study

The role of anxiety, depression, and psychological stress on the clinical status of recurrent aphthous stomatitis and oral lichen planus

Extraintestinal Manifestations of Celiac Disease

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