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

Abstract

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.

Assessing the proposed association between DED and gluten‐free diet introduction in celiac children

“…DEDs may be a result of the nutrients malabsorption, especially calcium, during the period of undetected CD . ) Therefore, the age at diagnosis and consequent GFD introduction could play an important role in enamel development .…”

“…DEDs are a common alteration in CD individuals and its prevalence ranges between 38% to over 80% . DEDs tend to present a symmetrical phenotype in all four hemiarches, in which the most commonly affected teeth are incisors and molars …”

“…Although a strong association between CD and DEDs has been widely reported, the nature of this relationship is still largely unclear. There are some theories whether CD and DEDs share a common genetic background or if DEDs are caused by the CD nutritional deficiencies.…”

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

“…According to Mariani et al the presence of a specific antigen -HLA-DR3, causes a significant increase in the risk of dental enamel development defects [28]. Erriu et al in turn, have observed a significant positive correlation between the expression of HLA-DQB1*02 and the defects in question [29].…”

Systemic and Oral Aspects in Celiac Disease for Dentistry

“…In a research with the aim to correlate the DC and the appearance of oral signs, it was found, in 44 pediatric patients with CD, a prevalence of 38.6% of defects in tooth enamel [35].…”