Gliadin antibodies identify gluten‐sensitive oral ulceration in the absence of villous atrophy

O’Farrelly, Cliona; O’Mahony, Christine A.; Graeme‐Cook, Fiona; Feighery, Conleth; McCartan, Bernard E.; Weir, Donald G.

doi:10.1111/j.1600-0714.1991.tb00407.x

Cited by 25 publications

(10 citation statements)

References 21 publications

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“…(Table 3). Rose et al (24) and O'Farrelly et al (25) reported that it was unnecessary to perform jejunal biopsy in patients with RAS. In our study group, which included 82 patients, 3 (3.6%) were AGA IgG positive and 2 (2.4%) were AGA IgA positive, whereas in the control group that included the same number of patients, 1 (1.2%) was AGA IgG and AGA IgA positive.…”

Section: Discussionmentioning

confidence: 99%

Clinical importance of celiac disease in patients with recurrent aphthous stomatitis

Yaşar¹,

Yaşar²,

Abut³

et al. 2012

Turk J Gastroenterol

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Section: Discussionmentioning

confidence: 99%

Clinical importance of celiac disease in patients with recurrent aphthous stomatitis

Yaşar¹,

Yaşar²,

Abut³

et al. 2012

Turk J Gastroenterol

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“…The effect of gluten-free diet (GFD) on remission of RAS is still uncertain, as dietary withdrawal of gluten occasionally results in significant benefit whereas some studies reported it ineffective [11,35,36]. Four patients accepted to start GFD, and all of them showed a significant improvement within 2–6 months after beginning of GFD.…”

Section: Discussionmentioning

confidence: 99%

Gluten sensitivity enteropathy in patients with recurrent aphthous stomatitis

et al. 2009

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BackgroundGluten sensitive enteropathy (GSE) is an autoimmune enteropathy triggered by the ingestion of gluten-containing grains in susceptible individuals. Recurrent aphthous stomatitis (RAS) may be the sole manifestation of GSE. The aim of this study was to determine the prevalence of gluten sensitivity enteropathy (GSE) in a large group of patients with RAS and assess the efficacy of gluten free diet (GFD) on the improvement of aphthous lesions in those who were diagnosed with GSE.MethodsTwo hundred and forty seven patients with RAS were included. The patients had at least three aphthous attacks per year. Patients were screened by IgA anti-endomysial antibody (EMA), IgA anti tissue transglutaminase (TTG) and serum IgA level. Those with a positive serology underwent endoscopic biopsies of the duodenal mucosa and patients with negative serology were excluded. The diagnosis of GSE was based on a positive serological test and abnormal duodenal histology. For patients with GSE, gluten free diet was recommended.ResultsSix out of 247 RAS patients had positive TTG test alone, and one had positive EMA and TTG. All 7 patients with positive serologic tests underwent duodenal biopsies. Histological findings were compatible with GSE in all of them (Marsh I in four patients, Marsh II in two patients and Marsh IIIB in one another.). The mean age of GSE patients was 27.42 ± 10.56 (range, 13 to 40) years old. They were suffering from RAS for an average duration of 4.5 years. All of the 7 GSE patients had not responded to the routine anti-aphthae medications, including topical corticosteroids, tetracycline and colchicine. Four patients who adhered to a strict gluten-free diet showed noticeable improvement in their aphthous lesions over a period of 6 months.ConclusionA significant minority (e.g. 2.83%) of RAS patients have GSE. This could be compared with the 0.9% prevalence of GSE in the general population of Iran. This study suggests that evaluation for celiac disease is appropriate in patients with RAS. Additionally, the unresponsiveness to conventional anti-aphthae treatment could be an additional risk indicator.

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“…Our patient developed gastrointestinal abnormalities consistent with coeliac disease after clinical manifestations of sensitivity to gluten were confined to the oral cavity for a prolonged time. Our group's previous study of 10 patients with sensitivity to gluten and recurrent oral ulcers showed clinical and serological relapse after challenge with gluten, although there was no histological or symptomatic evidence of gastrointestinal disease 4. This patient also showed no abnormality in the three original biopsy specimens of small intestine taken when oral ulcers were present.…”

Section: Discussionmentioning

confidence: 58%

Lesson of the week: Emergence of classic enteropathy after longstanding gluten sensitive oral ulceration

Srinivasan

Weir²,

Feighery³

et al. 1998

BMJ

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Gliadin antibodies identify gluten‐sensitive oral ulceration in the absence of villous atrophy

Cited by 25 publications

References 21 publications

Clinical importance of celiac disease in patients with recurrent aphthous stomatitis

Clinical importance of celiac disease in patients with recurrent aphthous stomatitis

Gluten sensitivity enteropathy in patients with recurrent aphthous stomatitis

Lesson of the week: Emergence of classic enteropathy after longstanding gluten sensitive oral ulceration

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