Prevalence of celiac disease in patients with recurrent aphthous stomatitis

ABSTRACT

Celiac disease [CD] is an immune-mediated inflammation of the small intestine caused by sensitivity to dietary gluten and related proteins in genetically sensitive individuals. Recurrent aphthous stomatitis [RAS] is an inflammatory condition characterized by painful recurrent, single or multiple ulcerations of the oral mucosa. The association between CD and RAS has been evaluated in several studies. The purpose of this study was to determine the prevalence of CD in patients with RAS. This was a prospective cross-sectional study that enrolled 181 patients with recurrent oral ulcers [at least three attacks per year]. Patients' peripheral blood samples were studied in terms of anti-tissue transglutaminase [anti-tTG] antibodies [IgA], anti-endomysial antibody [IgA] and serum IgA levels. Each patient that had a positive celiac serology underwent a duodenal biopsy. Information from all patients was entered into checklists. After completion of the checklists, the obtained data were analyzed by SPSS v19 statistical software. Of the 181 enrolled patients with recurrent aphthous, 43 [23.75%] were male and 138 [76.25%] were female. Average age of these patients was 28.45 +/- 12.27 years. The average age of disease onset was 23.39 +/- 9.46 years. Serologic survey results showed that only 2 patients were positive for these antibodies - both were women whose average age was 29 years. The average age of their disease onset was 22.5 years and biopsy results confirmed the presence of lymphocytic enteritis with crypt hyperplasia [Marsh II]. According to the results of this study, although there is a low prevalence of CD in patients with RAS, screening RAS patients for key serological markers of CD has clinical value.