Document Type : Original Article

Authors

1 Professor of Oral and Maxillofacial Medicine, Oral and Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

2 Associate Professor of Oral and Maxillofacial Medicine, Oral and Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

3 Assistant Professor of Gastroenterology and Hepatology, Gastroenterology and Hepatology Department, Mashhad University of Medical Sciences, Mashhad, Iran

4 Oral and Maxillofacial Medicine Specialist, Oral and Maxillofacial Medicine Department, Faculty of Dentistry, North Khorasan University of Medical Sciences, Bojnurd, Iran

Abstract

Background: Lichen planus is an autoimmune disorder and is associated with other autoimmune diseases. There is, however, little evidence of the association of oral lichen planus with celiac disease. The aim of this work was to investigate, for the first time, such an association in patients in the city of Mashhad, Iran.
Methods: This case-control study was performed during October 2017 to March 2018 in the department of Oral and Maxillofacial Medicine, Faculty of Dentistry, Mashhad University of Medical Sciences, in Iran. All participants were evaluated for Anti-TTG (IgA) and Total IgA, and in some cases for Anti-TTG IgG. Data were analyzed using SPSS software v.20.
Results: A total of 96 subjects were considered in the study; 32 in the case group, and the rest in the control group. The mean value of Anti-TTG IgA was 0.12 ± 1.51 Au/ml in the oral lichen planus group, while it was 0.57 ± 1.20 Au/ml in the control group with no significant difference (P=0.167). The mean value of the Total IgA was 134.96 ± 42.86 mg/dl in the lichen planus group, and it was 129.85 ± 55.28 mg/dl in the control group, as they differ negligibly either (P=0.639). Moreover, celiac disease was not present in the population.
Conclusions: We showed that there was no celiac disease present in the oral lichen planus patients as well as healthy subjects. Further studies are required to imply or to rule out the association of oral lichen planus and celiac disease.

Keywords

  1. Lodi G, Scully C, Carrozzo M, Griffiths M, Sugerman PB, Thongprasom K. Current controversies in oral lichen planus: report of an international consensus meeting. Part 2. Clinical management and malignant transformation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2005; 100(2):164-78.
  2. Erickson BA, Elliott SP, Myers JB, Voelzke BB, Smith 3rd TG, McClung CD, et al. Understanding the relationship between chronic systemic disease and lichen sclerosus urethral strictures. J Urol 2016; 195(2):363-8.
  3. Kurago ZB. Etiology and pathogenesis of oral lichen planus: an overview. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 122(1):72-80.
  4. Robledo-Sierra J, Landin-Wilhelmsen K, Nyström HF, Mattsson U, Jontell M. Clinical characteristics of patients with concomitant oral lichen planus and thyroid disease. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 120(5):602-8.
  5. Carrozzo M. How common is oral lichen planus? Evid Based Dent 2008; 9(4):112-3.
  6. Gupta S, Jawanda MK. Oral lichen planus: an update on etiology, pathogenesis, clinical presentation, diagnosis and management. Indian J Dermatol 2015; 60(3):222-9.
  7. Rashid M, Zarkadas M, Anca A, Limeback H. Oral manifestations of celiac disease: a clinical guide for dentists. J Can Dent Assoc 2011; 77(b39).
  8. Ruiz Villaverde R, Blasco Melguizo J, Menéndez García Estrada A, Díez García F. Erosive mucosal lichen associated to hyper IgE syndrome and coeliac disease. An Pediatr (Barc) 2004; 60(3):281-2. [In Spanish].
  9. Compilato D, Carroccio A, Campisi G. Hidden coeliac disease in patients suffering from oral lichen planus. J Eur Acad Dermatol Venereol 2012; 26(26):390-1.
  10. Fortune F, Buchanan J. Oral lichen planus and coeliac disease. Lancet 1993; 341(8853):1154-5.
  11. Acar S, Yetkıner AA, Ersın N, Oncag O, Aydogdu S, Arıkan C. Oral findings and salivary parameters in children with celiac disease: a preliminary study. Med Princ Pract 2012; 21(2):129-33.
  12. Muñoz F, Del Río N, Sóñora C, Tiscornia I, Marco A, Hernández A. Enamel defects associated with coeliac disease: putative role of antibodies against gliadin in pathogenesis. Eur J Oral Sci 2012; 120(2):104-12.
  13. Green PH, Rostami K, Marsh MN. Diagnosis of coeliac disease. Best Practice & Research Clinical Gastroenterology 2005; 19(3):389-400.
  14. Cigic L, Gavic L, Simunic M, Ardalic Z, Biocina-Lukenda D. Increased prevalence of celiac disease in patients with oral lichen planus. Clin Oral Investig 2015; 19(3):627-35.
  15. Rodrigo L, Beteta-Gorriti V, Alvarez N, Gómez de Castro C, de Dios A, Palacios L, et al. Cutaneous and Mucosal Manifestations Associated with Celiac Disease. Nutrients 2018; 10(7):800.
  16. Goddard CJ, Gillett HR. Complications of coeliac disease: are all patients at risk? Postgrad Med J 2006; 82(973):705-12.
  17. Nejad MR, Rostami K, Emami MH, Zali MR, Malekzadeh R. Epidemiology of celiac disease in Iran: a review. Middle East J Dig Dis 2011; 3(1):5-12.
  18. Pakfetrat A, Javadzadeh-Bolouri A, Basir-Shabestari S, Falaki F. Oral lichen planus: a retrospective study of 420 Iranian patients. Med Oral Patol Oral Cir Bucal 2009; 14(7):E315-8.
  19. Thongprasom K, Carrozzo M, Furness S, Lodi G. Interventions for treating oral lichen planus. Cochrane Database Syst Rev 2011; 7:CD001168.
  20. Losurdo G, Principi M, Iannone A, Amoruso A, Ierardi E, Di Leo A, et al. Extra-intestinal manifestations of non-celiac gluten sensitivity: an expanding paradigm. World J Gastroenterol 2018; 24(14):1521-30.
  21. Catassi C, Bai JC, Bonaz B, Bouma G, Calabrò A, Carroccio A, et al. Non-celiac gluten sensitivity: the new frontier of gluten related disorders. Nutrients 2013; 5(10):3839-53.
  22. Catassi C, Elli L, Bonaz B, Bouma G, Carroccio A, Castillejo G, et al. Diagnosis of non-celiac gluten sensitivity (NCGS): the Salerno experts’ criteria. Nutrients 2015; 7(6):4966-77.
  23. Spencer J, Sollid LM. The human intestinal B-cell response. Mucosal Immunol 2016; 9(5):1113-24.
  24. Jabri B, Sollid LM. Mechanisms of disease: immunopathogenesis of celiac disease. Nat Clin Pract Gastroenterol Hepatol 2006; 3(9):516-25.
  25. Green PH, Jabri B. Celiac Disease. Annu Rev Med 2003; 57:207-21.
  26. Pastore L, Carroccio A, Compilato D, Panzarella V, Serpico R, Muzio LL. Oral manifestations of celiac disease. J Clin Gastroenterol 2008; 42(3):224-32.
  27. Scully C, Porter SR, Eveson JW. Oral lichen planus and coeliac disease. Lancet 1993; 341(8861):1660.
  28. Jokinen J, Peters U, Mäki M, Miettinen A, Collin P. Celiac sprue in patients with chronic oral mucosal symptoms. J Clin Gastroenterol 1998; 26(1):23-6.
  29. Compilato D, Carroccio A, Campisi G. Hidden coeliac disease in patients suffering from oral lichen planus. J Eur Acad Dermatol Venereol 2012; 26(3):390-1.
  30. Nosratzehi T. Oral lichen planus: an overview of potential risk factors, biomarkers and treatments. Asian Pac J Cancer Prev 2018; 19(5):1161-7.