Clinical importance of celiac disease in patients with recurrent aphthous stomatitis.

Amac: Rekurren aftoz stomatit, oral mukozan›n nedeni bilinmeyen, tekrarlayan ar›l› ulserleri ile seyreden, s›k gorulen bir hasta- l›¤›d›r. Colyak hastal›¤› ve rekurren aftoz stomatit aras›ndaki iliflki birkac cal›flmada deerlendirilmifl ancak farkl› sonuclar bil- dirilmifltir. Bu cal›flman›n amac› rekurren aftoz stomatit'li hastalarda colyak hastal›¤› s›kl›¤›n› saptamakt›r. Yontem: Cal›flma grubu rekurren aftoz stomatit oykusu olan 82 hastadan, kontrol grubu ise rekurren aftoz stomatit oykusu olmayan 82 hastadan oluflturuldu. Tum olgularda IgA anti-endomisyum antikoru, IgG anti-endomisyum antikoru, IgA anti-gliadin antikoru ve IgG an- ti-gliadin antikoru bak›ld›. Serolojisi pozitif olan olgulara endoskopi yap›larak duodenum biyopsileri al›nd›. Ayr›ca her iki grup- taki olgular gastrointestinal semptomlar ac›s›ndan sorguland›. Bulgular: Cal›flma grubundaki 82 hastan›n birinde (%1.2) biyop- si ile colyak hastal›¤› tan›s› kondu. Go¤us arkas›nda yanma ve regurjitasyon gibi gastroozofageal semptomlar kontrol grubunda daha s›k idi (p<0.001, and p<0.001, s›ras›yla). Kontrol grubundaki 82 hastan›n hicbirinde colyak hastal›¤› saptanmad›. Sonuc: Rekurren aftoz stomatit ve colyak hastal›¤› aras›nda belirgin etyolojik balant› saptanmam›fl olup, rekurren aftoz stomatit'li has- talar›n colyak hastal›¤› ac›s›ndan taranmas›n›n klinik deeri dufluktur. Ek olarak, oral kavite icine mide asidi regurjitasyonu, af- toz stomatit oluflumunu kolaylaflt›r›yor olabilir. Anahtar kelimeler: Rukurran aftoz stomatit, colyak hastal›¤›, anti-gliadin antikoru, anti-endomisyum antikoru, gastroozofageal reflu hastal›¤› Background/aims: Recurrent aphthous stomatitis is a common disease of the oral mucosa that is characterized by recurrent, pa- inful ulcers of unknown etiology. The association between celiac disease and recurrent aphthous stomatitis has been evaluated in several studies, but variable results have been reported. The purpose of this study was to determine the prevalence of celiac disease in patients with recurrent aphthous stomatitis. Methods: The study group consisted of 82 patients, all of whom had a history of re- current aphthous stomatitis. The control group included 82 patients who did not have aphthous stomatitis. Patients were screened for IgA anti-endomysial antibodies, IgG anti-endomysial antibodies, IgA anti-gliadin antibodies, and IgG anti-gliadin antibodies. Patients with positive serology underwent endoscopic biopsies of the duodenal mucosa. Patients in both groups were also questio- ned regarding gastrointestinal symptoms. Results: One patient (1.2%) out of 82 in the study group was diagnosed with celiac di- sease by biopsy. Gastroesophageal reflux disease symptoms, heartburn and regurgitation were determined to be of higher incidence in the study group (p<0.001 and p<0.001, respectively). None of the 82 patients in the control group were diagnosed as having celi- ac disease. Conclusion: It is concluded that there is no apparent etiological link between recurrent aphthous stomatitis and celiac disease and that screening recurrent aphthous stomatitis patients for celiac disease has little clinical value. Additionally, regurgi- tation of gastric acid to the oral cavity may precipitate the formation of aphthous stomatitis.