hrvatski

Oral manifestations of Crohn's disease

Introduction: Crohn’s disease (CD) is a chronic inflammatory bowel disease that affects the entire digestive tube. Orofacial granulomatosis describes changes in the oral cavity without the involvement of the gastrointestinal tract, although some patients may have active subclinical disease or potential for developing CD. In patients with diagnosed CD changes of the oral cavity are called oral Crohn’s disease, and they can occur as side effects of pharmacological therapy, malabsorption, or nutritional deficits. Treatment is complex and involves treatment of primary intestinal disease combined with dental treatment. Methods: In this report, we describe the case of a girl with CD who developed severe chronic lesions in the oral cavity. Results: A 17-year- old girl suffers from an extensive form of CD which initially presented as pancolitis with sideropenic anemia. Over the years she had frequent relapses and pharmacotherapy was often modified. Clinical course seemed favorable, but typical changes persisted in the ileocaecal region (intersphinteric fistula). At the age of 16, she developed severe gingivitis and periodontitis with ulcer-like lesions. She was initially treated by periodontologist, but progressive changes aroused suspicion for oral Crohn’s disease. Antibiotic therapy showed partial effect and significant improvement was recorded only during short periods of corticosteroid therapy (local or systemic). Histologically the changes were described as hyperplastic gingivitis with chronic inflammatory changes, without granuloma. Conclusion: With this case, we wanted to recall another (extra- intestinal?) CD manifestation which can significantly impair the patient’s quality of life and requires cooperation between gastroenterologists and dental specialists.

Crohn’s disease ; orofacial granulomatosis ; hyperplastic gingivitis

nije evidentirano

engleski

Oral manifestations of Crohn's disease

Introduction: Crohn’s disease (CD) is a chronic inflammatory bowel disease that affects the entire digestive tube. Orofacial granulomatosis describes changes in the oral cavity without the involvement of the gastrointestinal tract, although some patients may have active subclinical disease or potential for developing CD. In patients with diagnosed CD changes of the oral cavity are called oral Crohn’s disease, and they can occur as side effects of pharmacological therapy, malabsorption, or nutritional deficits. Treatment is complex and involves treatment of primary intestinal disease combined with dental treatment. Methods: In this report, we describe the case of a girl with CD who developed severe chronic lesions in the oral cavity. Results: A 17-year- old girl suffers from an extensive form of CD which initially presented as pancolitis with sideropenic anemia. Over the years she had frequent relapses and pharmacotherapy was often modified. Clinical course seemed favorable, but typical changes persisted in the ileocaecal region (intersphinteric fistula). At the age of 16, she developed severe gingivitis and periodontitis with ulcer-like lesions. She was initially treated by periodontologist, but progressive changes aroused suspicion for oral Crohn’s disease. Antibiotic therapy showed partial effect and significant improvement was recorded only during short periods of corticosteroid therapy (local or systemic). Histologically the changes were described as hyperplastic gingivitis with chronic inflammatory changes, without granuloma. Conclusion: With this case, we wanted to recall another (extra- intestinal?) CD manifestation which can significantly impair the patient’s quality of life and requires cooperation between gastroenterologists and dental specialists.

Crohn’s disease ; orofacial granulomatosis ; hyperplastic gingivitis

nije evidentirano