scholarly journals Oral Manifestations of Celiac Disease and Wheat Allergy: Report of Three Cases and Review of Literature

Author(s):  
Yadira V. Boza Oreamuno DDS, MSc ◽  
María F. Rugama Flores BSND

Celiac Disease (CD) is an immune-mediated systemic disease, caused by gluten and related prolamins, in genetically susceptible individuals. It is characterized by gluten-dependent clinical manifestations, CD-specific antibodies, HLA DQ2 or DQ8 haplotypes, and enteropathy. Most patients are asymptomatic or with mild manifestations. It mainly affects the gastrointestinal system causing symptoms and signs such as diarrhea, recurrent abdominal pain and abdominal distension; also extradigestive manifestations. Patients with CD may have oral manifestations that include recurrent aphthous stomatitis (RAS), enamel hypoplasia, atrophic glossitis, among others. The diagnosis of CD is based on clinical history, serology, endoscopy and histology. There are other entities that should be differentiated from CD, such as non-celiac gluten sensitivity and wheat allergy. The aim of this study is to present three patients with a history of RAS and other clinical manifestations associated with the early diagnosis of CD and food allergy.

2021 ◽  
Vol 49 (5) ◽  
pp. 030006052110122
Author(s):  
Yimin Ma ◽  
Duanming Zhuang ◽  
Zhenguo Qiao

Celiac disease (CD) is a chronic immune-mediated intestinal disease that is characterized by production of autoantibodies directed against the small intestine. The main clinical manifestations of CD are typically defined as those related to indigestion and malabsorption. These manifestations include unexplained diarrhea or constipation, abdominal pain, bloating, weight loss, anemia, failure-to-thrive in children, and decreased bone density. Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by heterogeneous clinical manifestations, which may also involve the gastrointestinal tract. Comorbidity of CD and SLE is rare, and the overlapping symptoms and nonspecific clinical presentation may pose a diagnostic challenge to clinicians. We report here a case of SLE with CD, which mainly manifested as recurrent diarrhea, uncorrectable electrolyte disorders, and severe malnutrition. Through review, we hope to further improve our understanding and diagnostic level of this combination of diseases.


2019 ◽  
Vol 56 (2) ◽  
pp. 160-164 ◽  
Author(s):  
Eduardo Pachu Raia dos SANTOS ◽  
Fernando SANTA CRUZ ◽  
Eduarda Araújo HINRICHSEN ◽  
Álvaro Antônio Bandeira FERRAZ ◽  
Josemberg Marins CAMPOS

ABSTRACT BACKGROUND: Internal hernia (IH) following laparoscopic Roux-en-Y gastric bypass (LRYGB) is a major complication that challenges the surgeon due to its non-specific presentation and necessity of early repair. Delayed diagnosis and surgical intervention of IH might lead to increased morbidity of patients and impairments in their quality of life. OBJECTIVE: To evaluate the predictive factors for early diagnosis and surgical repair of IH after LRYGB. METHODS: This study analyzed 38 patients during the postoperative period of LRYGB who presented clinical manifestations suggestive of IH after an average of 24 months following the bariatric procedure. RESULTS: The sample consisted of 10 men and 28 women, with a mean age of 37.5 years and a mean body mass index (BMI) of 39.6 kg/m2 before LRYGB. All patients presented pain, 23 presented abdominal distension, 10 had nausea and 12 were vomiting; three of them had dysphagia, three had diarrhea and one had gastro-esophageal reflux. The patients presented symptoms for an average of 15 days, varying from 3 to 50 days. Seventeen (45.9%) patients were seen once, while the other 20 (54.1%) went to the emergency room twice or more times. Exploratory laparoscopy was performed on all patients, being converted to laparotomy in three cases. Petersen hernia was confirmed in 22 (57.9%). Petersen space was closed in all patients and the IH correction was performed in 20 (52.6%) cases. The herniated loop showed signs of vascular suffering in seven patients, and two (5.3%) had irreversible ischemia, requiring bowel resection. CONCLUSION: The presence of recurrent abdominal pain is one of the main indicators for the diagnosis of IH after LRYGB. Patients operated at an early stage, even with negative imaging tests for this disease, benefited from rapid and simple procedures without major complications.


2021 ◽  
Vol 12 (9) ◽  
pp. 156-159
Author(s):  
Hina Ismail ◽  
Zain Majid ◽  
Zahid Shah ◽  
Ghazi Abrar ◽  
Raja Taha Yaseen Khan ◽  
...  

Celiac disease is an immune mediated enteropathy that causes malabsorption. It is associated with a number of autoimmune diseases, however is rarely associated with Budd chiari syndrome. We present a case of a young girl who was a diagnosed case of celiac disease and had presented with abdominal distension along with pedal edema. Her initial workup was all negative while ultrasound abdomen along with CT scan abdomen had given the impression of Budd chiari syndrome. She was managed with gluten free diet, diuretics along with anticoagulants.


1921 ◽  
Vol 33 (4) ◽  
pp. 525-538 ◽  
Author(s):  
Wade H. Brown ◽  
Louise Pearce ◽  
William D. Witherbee

A systematic study was made of the affections of bone, cartilage, tendons, and synovial membranes which occurred in a series of rabbits with generalized syphilis. Localized infection of this group of structures was found to be of very frequent occurrence. The parts involved were, in the order of their frequency, the facial and cranial bones and cartilages, the bones, tendons, and joints of the feet and legs, the cervical and caudal vertebræ, the ribs, and the sternum. These infections often gave rise to characteristic manifestations of disease which could be detected without difficulty by inspection or palpation of the part. In many instances, however, clinical manifestations were so slight that the presence of lesions could be detected only by radiographic or pathological examination. Detailed descriptions of various clinical types of disease were given and the clinical manifestations correlated with the pathological process. It was pointed out that bone lesions exhibited a decided predilection for certain exposed bony prominences, for lines of bony union, and for epiphyseal lines in particular. A study of the clinical history of bone lesions brought out the fact that they were among the earliest of the generalized forms of disease; they tended to pursue a comparatively rapid course, and relapse was never observed. Especial emphasis was laid upon three aspects of the experimental infection: the analogy existing between certain forms of the animal and human affections, the relation of syphilis of the osseous system to other evidences of disease, and the occurrence of obscure bone lesions. In this connection, it was pointed out that the nasal and epiphyseal lesions of the rabbit presented a striking analogy to those of congenital syphilis in man. It was also pointed out that syphilis of the osseous system occupied a definite position in the scheme of defensive reactions such that lesions of these tissues might be favored or inhibited according to the experimental conditions employed. Finally, the frequency with which infections occurred which were not accompanied by sufficiently distinctive signs even to suggest the possibility of their existence was interpreted as evidence that some cases of latent or obscure infection in man might find their explanation in the presence of a similar group of affections.


2014 ◽  
Vol 6 (2) ◽  
pp. 69-72
Author(s):  
Ljubka Miteva ◽  
Valentina Broshtilova ◽  
Robert A. Schwartz

Abstract A 22-year-old woman with a 3-year history of discoid lupus erythematosus presented with two circumscribed patches of non-scarring alopecia, clinically simulating alopecia areata. Histopathological analysis of scalp lesions revealed discoid lupus erythematosus. Based on the clinical history, physical examination, and histological and immunological findings, we distinguished our case from a true combination of alopecia areata and typical chronic discoid lupus erythematosus.


2020 ◽  
Vol 19 (5) ◽  
pp. 371-378
Author(s):  
Aelita A. Kamalova ◽  
Daria O. Timofeeva ◽  
Almazia R. Shakirova

Celiac disease is an immune-mediated systemic disorder caused by gluten in people with genetic predisposition. Celiac disease is characterized by wide range of clinical manifestations (both gastroenterological and extraintestinal), that can complicate the diagnosis. Thus, celiac disease often remains undiagnosed. ESPGHAN has published updated clinical guidelines with adjusted coeliac disease diagnosis algorithms in 2020. It is proposed to determine antibodies to tissue transglutaminase (TGA-IgA) and total IgA within normal content of gluten-containing products in the diet on the first stage of children screening. The diagnosis of celiac disease can be established without small intestine biopsy in case of increased levels of TGA-IgA ≥ 10 of upper limit of normal and presence of antibodies to endomysium (EMA-IgA) in secondary serum. In such cases, ESPGHAN does not recommend any additional genetic testing to confirm celiac disease as it does not increase the reliability of the diagnosis. Antigen tests on class G or A antibodies against native gliadin are not specific and are not recommended for use in the diagnosis of celiac disease.


2016 ◽  
Vol 18 (1) ◽  
pp. 116
Author(s):  
Daniela Iacob ◽  
Otilia Fufezan ◽  
Dorin Farcău ◽  
Gabriel Samaşcă ◽  
Adriana Slavcovici ◽  
...  

Celiac disease is a chronic immune-mediated disorder induced in genetically susceptible individuals after ingestion of gluten proteins. An early diagnosis is of highest importance. Ultrasound might show small-bowel intussusception. We present a toddler with one month history of diarrhea and abdominal ultrasound showing ileo-ileal intussusception. Specific serological markers for celiac disease were positive. The duodenal endoscopy showed normal architecture but pathology indicated fully developed celiac disease (Marsh 3c). In conclusion, toddlers, who have even a short history of diarrhea with ultrasound showing ileo-ileal intussusception, can be suspected of celiac disease by positive serologic markers and can be confirmed by duodenal biopsy and pathology.


2019 ◽  
pp. 208-244
Author(s):  
Jeffrey A. Allen

This chapter begins with a history of chronic immunological neuropathies. It then looks in particular at chronic inflammatory demyelinating polyneuropathy (CIDP), which is an immune-mediated peripheral nerve disorder characterized by progressive or relapsing motor or sensory symptoms. It then considers the epidemiology, clinical manifestations, and electrophysiology of CIDP. The chapter examines diagnostic data and diagnostic criteria for CIDP. It then looks at other neuropathies with clinical and electrophysiologic features that are shared with CIDP. Particular attention is given to neuropathy associated with monoclonal gammopathy including IgM associated neuropathy and POEMS syndrome, polyneuropathies associated with specific autoantibodies including antibodies that target nodal and paranodal structures, and multifocal motor neuropathy. For each condition diagnostic data, pathophysiology and treatment are discussed.


2020 ◽  
Vol 21 (6) ◽  
pp. 452-466 ◽  
Author(s):  
Taher Azimi ◽  
Ahmad Nasser ◽  
Aref Shariati ◽  
Seyedeh M.J. Shiadeh ◽  
Hossein Safari ◽  
...  

Celiac Disease (CD) is an immune-mediated enteropathy, generally of the proximal intestine, that occurs in genetically susceptible individuals triggered by the ingestion of gluten. The incidence and frequency of CD are increasing, and it is predicted that CD affects approximately 1% of the people worldwide. The common clinical manifestations of CD are divided in two sections, including classic and non-classic symptoms that can be created in childhood and adulthood. The relationship between pathogenic and non-pathogenic bacteria with CD is complex and multidirectional. In previous published studies, results demonstrated the triggering impact of bacteria, viruses, and parasites on initiation and development of Inflammatory Bowel Disease (IBD) and Irritable Bowel Syndrome (IBS). Different studies revealed the inducing effect of pathogenic and non-pathogenic bacteria on CD. However, increasing evidence proposes that some of these microorganisms can also play several positive roles in CD process. Although information of the pathogenesis of the CD is quickly expanding, the possible role of bacteria needs further examination. In conclusion, with respect to the possible correlation between different bacteria in CD, the current review-based study aims to discuss the possible relationship between CD and pathogenic and non-pathogenic bacteria and to show various and significant aspects of mechanisms involved in the CD process.


2018 ◽  
Vol 8 (1) ◽  
pp. 21 ◽  
Author(s):  
Roberta Gualtierotti ◽  
Angelo Marzano ◽  
Francesco Spadari ◽  
Massimo Cugno

Oral manifestations are frequent in patients with rheumatic diseases. The aim of this review is to offer readers practical advice concerning the onset, diagnosis and treatment of the main oral manifestations encountered in rheumatological and dental clinics. Signs and symptoms such as oral hyposalivation, xerostomia, temporomandibular joint disorders, periodontal disease, and dysphagia may be the first expression of a number of rheumatic diseases. Some of these manifestations are aspecific and very frequent, such as oral aphthosis, which can be the first manifestation in patients with systemic lupus erythematosus; some are potentially dangerous, such as jaw claudication during the course of giant cell arteritis; and some are very rare but peculiar, such as strawberry-like gingivitis in patients with granulomatosis with polyangiitis. Other oral manifestations are due to adverse reactions to disease-modifying anti-rheumatic drugs. Oral alterations in rheumatic diseases are frequently overlooked in clinical practice, but their prompt recognition not only allows the local lesions to be appropriately treated, but also makes it possible to identify an underlying systemic disease.


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