%0 Journal Article
%T Oral Signs and HLA-DQB1*02 Haplotypes in the Celiac Paediatric Patient: A Preliminary Study
%A M. Erriu
%A G. M. Abbate
%A F. M. G. Pili
%A F. Novara
%A G. Orr¨´
%A C. Montaldo
%A V. Piras
%A L. Levrini
%J Autoimmune Diseases
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/389590
%X Celiac disease (CD) diagnosis can be extremely challenging in the case of atypical patterns. In this context, oral signs seem to play a decisive role in arousing suspicion of these forms of the disease. At the same time, the different expressions of the HLA-DQB1*02 allele apparently seem to facilitate the interpretation of signs and highlighted symptoms. The aim of this work was to verify whether it is possible to identify a correlation between the development of oral signs and different DQ2 haplotypes in celiac pediatric patients. 44 celiac patients with a medium age of 9.9 were studied. Oral examinations were performed in order to identify recurrent aphthous stomatitis (RAS) and dental enamel defects (DED). The diagnosis of DED resulted as being related to allele expression ( value = 0.042) while it was impossible to find a similar correlation with RAS. When both oral signs were considered, there was an increase in correlation with HLA-DQB1*02 expression ( value = 0.018). The obtained results identified both the fundamental role that dentists can play in early diagnosis of CD, as well as the possible role of HLA haplotype analysis in arousing suspicion of atypical forms of the disease. 1. Introduction Celiac disease (CD) is a complex pathologic condition involving the small intestine mucosa resulting from intolerance to gluten assumption [1]. More specifically, it is considered a genetic and autoimmune condition that can affect patients of any age and gender with a great variability of symptoms and clinical signs. Although the final diagnosis of CD is always based on a biopsy with the detection of severe villous atrophy coupled with crypt hyperplasia, the diagnostic pathway leading to this conclusion can often be long and winding [1, 2]. This pathology, initially considered as typical of the European population, is nowadays distributed worldwide. Epidemiological analysis has reported a prevalence of celiac disease as varying greatly between the western and the eastern parts of the world, so that CD is today considered as the most common genetic disorder in the west with a prevalence of 1%, while it is relatively unknown in Asian countries [1, 3]. This irregular distribution in different countries has been related to genetic and alimentary factors. CD is actually an intestinal enteropathy whose symptoms are determined by the ingestion of gliadin in genetically predisposed patients [1]. Gliadin is a prolamin, a class of peptides highly resistant to gastrointestinal enzymes, which causes histological changes in the small intestine mucosa of the celiac
%U http://www.hindawi.com/journals/ad/2013/389590/