Clinical and immunopathological evaluation of oral mucosa in coeliac disease

Objective: The aim of the study was to perform clinical and immunopathological evaluation of the oral mucosa in adults with coeliac disease.

Method: Clinical condition of the oral mucosa was evaluated in 30 adults aged 16-65 with diagnosed celiac disease. Immunopathologic investigation with the direct immunofluorescence method (DIF) was performed in 10 subjects from the study group. Buccal mucosa bioptates collected in local anesthesia were routinely processed with polyclonal rabbit antibodies against human IgG, IgA, IgM and C-3. The presence of immunoglobulin deposits was demonstrated using the optic microscope (Zeiss) with fluorescent attachment and digital camera (Olympus). Statistical analysis was performed with bilateral Fisher test with the significance level P<0.05.

Result: Most commonly observed oral mucosal lesions in patients with coeliac disease included: atrophic glossitis (36.6%)- of acute (26.6%) and chronic (10.0%) type, mucosal cobblestoning (23%), aphthous-like eruptions reported in the history (66.6%), recurrent aphthous stomatitis present during the examination (16.6%), mucosal and skin palor (20.0%) and angular cheilitis (16.6%). In none of the oral mucosa bioptates the deposits of IgA, IgG, IgM and C3 were revealed along the oral mucosa basal membrane.

Conclusion:

1. In patients with coeliac disease atrophic glossitis, mucosal cobblestoning, recurrent aphthous stomatitis, mucosal and skin palor and angular cheilitis appear frequently.

2. The presence of IgA, IgG, IgM and C3 deposits in oral mucosa cannot be considered as a diagnostics marker in coeliac disease.