Idiopathic atrophic glossitis as the only clinical sign for celiac disease diagnosis: a case report.
J Med Case Rep. 2012 Jul 4 ;6(1):185. Epub 2012 Jul 4. PMID: 22762365
ABSTRACT: INTRODUCTION: The aim of this case report is to show how an oral condition, such as atrophic glossitis, can bethe 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 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 vitamindeficiency 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 asmall 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-freediet, the oral clinician was not able to find any signs of atrophic glossitis. CONCLUSIONS: 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 diseaseand 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.