Abstract
IntroductionThe aim of this case report is to show how an oral condition, such as atrophic glossitis, can be the only clinical sign that allows an early diagnosis of celiac disease.Case presentationAtrophic glossitis was detected by a dentist during a first routine examination of the oral cavity of a 17-year-old Sardinian young woman and then differential diagnosis was carried out to identify the etiology of her tongue condition. Considering the high prevalence of celiac disease in the patient’s birth area, the clinician took a blood sample to search for vitamin deficiency and immunological anomalies typically linked to celiac disease. Positive blood sample results allowed the patient to be referred to a gastroenterologist in order to perform a small intestine biopsy. The biopsy showed a strong atrophy of the intestinal villus so that it was possible to make a sure diagnosis of celiac disease. After five months on a gluten-free diet, the oral clinician was not able to find any signs of atrophic glossitis.ConclusionsTwo important conclusions can be reached from this case report; first, the fundamental role played by the oral condition alone in finding and highlighting atypical forms of celiac disease and second, the importance of investigating systemic anomalies, in cases where there is a tongue condition such as atrophic glossitis and when it is impossible to identify local causes.
Highlights
ConclusionsTwo important conclusions can be reached from this case report; first, the fundamental role played by the oral condition alone in finding and highlighting atypical forms of celiac disease and second, the importance of investigating systemic anomalies, in cases where there is a tongue condition such as atrophic glossitis and when it is impossible to identify local causes
The aim of this case report is to show how an oral condition, such as atrophic glossitis, can be the only clinical sign that allows an early diagnosis of celiac disease.Case presentation: Atrophic glossitis was detected by a dentist during a first routine examination of the oral cavity of a 17-year-old Sardinian young woman and differential diagnosis was carried out to identify the etiology of her tongue condition
Two important conclusions can be reached from this case report; first, the fundamental role played by the oral condition alone in finding and highlighting atypical forms of celiac disease and second, the importance of investigating systemic anomalies, in cases where there is a tongue condition such as atrophic glossitis and when it is impossible to identify local causes
Summary
Abnormalities of the tongue can represent an unclear pathology for the dentist, especially when they are linked to autoimmune diseases or a nutritional deficiency. Different kinds of glossitis can be linked to systemic pathology usually not linked to common dental practice [2] For this reason, the clinician, after excluding local etiology through a differential diagnosis, ignores the disease instead of performing a more accurate analysis. This paper has demonstrated that the dentist must always work to discover the cause of tongue affection and that this goal can be achieved by working together with other specialists [2]. It has been shown how starting from an AG, the dentist in collaboration with the gastroenterologist, can have a fundamental role in CD diagnosis.
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