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

Srinivasan, Usha; Weir, Donald G.; Feighery, Conleth; O’Farrelly, Cliona

doi:10.1136/bmj.316.7126.206

Cited by 5 publications

(3 citation statements)

References 4 publications

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“…Routine administration of supplements to patients with RAS is not indicated; however, correction of documented deficiency may be helpful. Coeliac disease is associated with aphthous‐like ulceration, which may may preceed frank enteropathy [4] and resolve with a gluten‐free diet.…”

Section: Recurrent Aphthous Stomatitismentioning

confidence: 99%

Clinical Immunology Review Series: An approach to the patient with recurrent orogenital ulceration, including Behçet's syndrome

Keogan

2008

Clinical and Experimental Immunology

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ARTICLES PUBLISHED IN THIS CLINICAL IMMUNOLOGY REVIEW SERIES SummaryPatients presenting with recurrent orogenital ulcers may have complex aphthosis, Behçet's disease, secondary complex aphthosis (e.g. Reiter's syndrome, Crohn's disease, cyclical neutropenia) or non-aphthous disease (including bullous disorders, erythema multiforme, erosive lichen planus). Behçet's syndrome is a multi-system vasculitis of unknown aetiology for which there is no diagnostic test. Diagnosis is based on agreed clinical criteria that require recurrent oral ulcers and two of the following: recurrent genital ulcers, ocular inflammation, defined skin lesions and pathergy. The condition can present with a variety of symptoms, hence a high index of suspicion is necessary. The most common presentation is with recurrent mouth ulcers, often with genital ulcers; however, it may take some years before diagnostic criteria are met. All patients with idiopathic orogenital ulcers should be kept under review, with periodic focused assessment to detect evolution into Behçet's disease. There is often a delay of several years between patients fulfilling diagnostic criteria and a diagnosis being made, which may contribute to the morbidity of this condition. Despite considerable research effort, the aetiology and pathogenesis of this condition remains enigmatic.

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Section: Recurrent Aphthous Stomatitismentioning

confidence: 99%

Clinical Immunology Review Series: An approach to the patient with recurrent orogenital ulceration, including Behçet's syndrome

Keogan

2008

Clinical and Experimental Immunology

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“…Suggested aetiologies, include idiopathic haematinic deficiency, cessation of tobacco smoking and psychological stress, but there is little scientific evidence in support of any of these. While superficial ulcers similar to RAS may arise in gluten‐sensitive enteropathy, 48 the vast majority of patients with RAS have no clinical, gastroenterological or serological features of this small bowel disorder. To date no common viral or bacterial infection of the mouth has been implicated in the aetiology of RAS 47 .…”

Section: Recurrent Aphthous Stomatitismentioning

confidence: 99%

Review article: oral ulcers and its relevance to systemic disorders

Porter

Leão

2005

Aliment Pharmacol Ther

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Summary Oral ulceration is a common problem, and is sometimes a marker of gastroenterological disease. Patients with signs or symptoms of oral ulcers are sometimes referred to gastroenterology clinics, however, in most instances the ulcers does not reflect gastrointestinal disease. Indeed, a spectrum of disorders other than those of the gut can give rise to oral mucosal ulcers ranging from minor local trauma to significant local disease such as malignancy or systemic illness. This present article reviews aspects of the aetiology, diagnosis and management of common ulcerative disorders of the oral mucosa.

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“…50 Therapy for RAS is directed towards reducing the duration and/or frequency of episodes of ulceration. 51 Topical corticosteroids are used in the most cases; however, few of these have been found to be significantly effective in appropriate clinical studies. Chlorhexidine gluconate mouth rinse may be of some benefit (and has been evaluated in detail), 52 but it has only limited clinical value in the management of RAS.…”

Section: Recurrent Aphthous Stomatitismentioning

confidence: 99%

Ulcerative Lesions of the Mouth: An Update for the General Medical Practitioner

Leão

Gomes

Porter

2007

Clinics

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Leão JC, Gomes VB, Porter S. Ulcerative lesions of the mouth: an update for the general medical practitioner. Clinics. 2007;62(6):769-80.Oral ulceration is a common complaint of patients attending out-patient clinics. Because of the diversity in causes of oral ulceration, patients presenting with oral mucosal disease can be challenging to diagnose and manage. Patients with signs or symptoms of oral ulcers are sometimes referred to gastroenterology clinics; however, in most instances the ulcers do not result from gastrointestinal disease. The aim of the present article is to review aspects of the etiology, diagnosis and management of common ulcerative disorders of the oral mucosa. A search in the National Library of Medicine computerized bibliographic database MEDLINE was performed. Selection of publications, extraction of data, and validity assessment were then performed by the authors. Based upon the searched literature, it is concluded that there are several systemic disorders that can present with similar clinical signs and symptoms, and knowledge of each disease is necessary for the clinician to provide proper management.

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

Cited by 5 publications

References 4 publications

Clinical Immunology Review Series: An approach to the patient with recurrent orogenital ulceration, including Behçet's syndrome

Clinical Immunology Review Series: An approach to the patient with recurrent orogenital ulceration, including Behçet's syndrome

Review article: oral ulcers and its relevance to systemic disorders

Ulcerative Lesions of the Mouth: An Update for the General Medical Practitioner

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