scholarly journals SUBSTANTIATION OF DIAGNOSIS AND TREATMENT OF CHRONIC RECURRENT APHTHOUS STOMATITIS IN CROHN’S DISEASE

2020 ◽  
Vol 73 (3) ◽  
pp. 512-516
Author(s):  
Oksana Y. Feleshtynska ◽  
Olena O. Dyadyk
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Oral Mucosa ◽  
Morphological Study ◽  
Comparison Group ◽  
Granulomatous Inflammation ◽  
Main Group ◽  
Recurrent Aphthous Stomatitis ◽  
Aphthous Stomatitis ◽  
Diagnosis And Treatment

The aim: To substantiate the diagnosis and treatment of chronic recurrent aphthous stomatitis in Crohn’s disease. Materials and methods: The analysis of diagnostic and treatment of 52 patients with chronic recurrent aphthous stomatitis in Crohn’s disease (main group), mean age 31.8 + 2.3 was performed. The comparison group consisted of 50 patients with chronic recurrent aphthous stomatitis not associated with Crohn’s disease (mean age 34.7 + 1.8). Patients in both groups were studied for clinical manifestations, morphological and immunohistochemical studies the aphthae on the oral mucosa were performed. Results: An objective evaluation of the oral mucosa showed that the aphthae on the oral mucosa in patients of both groups did not differ visually. In the morphological study, the patients in the main group had granulomatous inflammation of the oral mucosa, characteristic of Crohn’s disease, while the patients in the comparison group had fibrinous inflammation. Immunohistochemical study of the cell infiltrate phenotype in the area of the lesion revealed that the patients in the main group there prevailed CD68+macrophages, the appearance of both intraepithelial and cell infiltrates of T-lymphocyte suppressors, which is characteristic of Crohn’s disease. Conclusions: Diagnosis of chronic recurrent aphthous stomatitis in Crohn’s disease is based on biopsy of the aphthae on the oral mucosa and their morphological examination, the results of which confirm the presence of granulomatous inflammation, with a large number of macrophages, the presence of T-lymphocytes, characteristic of Crohn’s disease, while recurrent aphthous stomatitis of another genesis morphologically detect fibrinous inflammation. The choice of therapeutic tactics for chronic recurrent aphthous stomatitis depends on the results of the morphological study. When granulomatous inflammation is detected in patients with chronic recurrent aphthous stomatitis, which is characteristic of Crohn’s disease, in addition to topical treatment of the oral mucosa, specific therapy with mesalazine drugs is prescribed.

scholarly journals Aphthous stomatitis as the debut of Crohn’s disease

2020 ◽  
pp. 97-100
Author(s):  
O. V. Gaus ◽  
V. A. Akhmedov ◽  
A. S. Korshunov
Keyword(s):  
Crohn’S Disease ◽  
Gastrointestinal Tract ◽  
Crohn's Disease ◽  
Granulomatous Inflammation ◽  
Aphthous Stomatitis ◽  
Systemic Complications ◽  
Immune Mediated ◽  
Transmural Inflammation ◽  
Retromolar Region

Crohn’s disease is an immune-mediated disease characterized by non-specific granulomatous transmural inflammation with segmental damage to any part of the gastrointestinal tract with the formation of extraintestinal and systemic complications. Clinical observation of patient I., 23 years old, a student who was sent for consultation to a gastroenterologist in the direction of a dentist, is presented. Active examination of the gastrointestinal tract during the inspection did not show any complaints. He considers himself ill for 6 months, when he first complained of pain in the neck, sore throat, and body temperature rise to 37.4–37.5 °C, mostly in the evening. Were treated by an otolaryngologist and a dentist without significant effect. In this connection, a biopsy of the ulcerative defect of the left retromolar region was performed, revealing noncaseating granulomatous inflammation. A follow-up examination by a gastroenterologist with colonoscopy and biopsy made it possible to establish Crohn’s disease as the true cause of aphthous stomatitis.

Postoperative Recurrence of Crohn's Disease: Pathophysiology, Diagnosis and Treatment

2018 ◽  
Vol 18 (12) ◽  
pp. 979-988 ◽  
Author(s):  
Antonio Di Sario ◽  
Paola Sassaroli ◽  
Luigi Daretti ◽  
Giulia Annulli ◽  
Laura Schiada ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Postoperative Recurrence ◽  
Diagnosis And Treatment

scholarly journals RECURRENT APHTHOUS STOMATITIS RELATED TO PSYCHOLOGICAL STRESS, FOOD ALLERGY AND GERD

2019 ◽  
Vol 6 ◽  
pp. 45
Author(s):  
Rina Kartika Sari ◽  
Diah Savitri Ernawati ◽  
Bagus Soebadi
Keyword(s):  
Food Allergy ◽  
Psychological Stress ◽  
Oral Mucosa ◽  
Recurrent Aphthous Stomatitis ◽  
Predisposing Factors ◽  
Aphthous Stomatitis ◽  
Cow Milk ◽  
Esophageal Mucosa ◽  
History Of ◽  
Multiple Ulcers

Background: Recurrent Aphthous Stomatitis (RAS) is inflammation in oral mucosa characterized by recurrent single or multiple ulcers that usually affected in non keratinized mucosa. Etiology RAS is unknown but psychological stress, allergy, and gastrointestinal disease can be predisposing factors Case Management: A 23rd years old complained recurrent oral ulcer with free ulcer period for 3-5 days. The patient had a history of food allergy, GERD and psychological stress. Intraoral examination showed recurrent multiple ulcers in variation site of the mouth. DASS 42 screening showed high stress and high anxiety. Skin Prick Test showed positive allergy to kapok, beef, chicken, cow milk, white egg, duck egg, shrimp, cob fish, milkfish, chocolate, and peanut. Ulcers treated with nonsteroid antiinflammation Aloe Vera gel and stress management by reading assignment method.Discussion: Psychological stress altered the immune system so oral mucosa prone to inflammation, and make the history of GERD getting worse. Stress causes cortisol secretion that changes the imbalance of proinflammatory and antiinflammatory cytokines. Oral mucosa becomes more susceptible to hypersensitivity. In addition, stress decreased oral and esophageal mucosa resistance to GERDConclusion: RAS triggered by psychological stress, allergy, and GERD. Treatment of RAS is by elimination predisposing factors to prevent recurrence.

CROHN’S DISEASE IN CHILDREN: THE CURRENT STATE OF THE PROBLEM

2021 ◽  
Vol 100 (6) ◽  
pp. 78-85
Author(s):  
A.S. Bekin ◽  
◽  
E.Yu. Dyakonova ◽  
A.N. Surkov ◽  
A.P. Fisenko ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Surgical Treatment ◽  
Crohn's Disease ◽  
Granulomatous Inflammation ◽  
Unknown Etiology ◽  
Systemic Complications ◽  
Current State ◽  
Conservative And Surgical Treatment ◽  
Scientific Ideas ◽  
Local And Systemic Complications

Crohn's disease (CD) is chronic recurrent bowel disease of unknown etiology, characterized by segmental transmural granulomatous inflammation, mainly with the development of local and systemic complications. Despite the active development of conservative therapy methods, the number of drug-resistant forms of CD and complications of the disease requiring surgical treatment continues to increase. The article reflects modern scientific ideas about the methods of diagnosis, conservative and surgical treatment of CD in children.

scholarly journals Unsuccessful Treatment of Cheilitis Granulomatosa with Oral Methotrexate

2019 ◽  
Vol 11 (3) ◽  
pp. 249-255 ◽  
Author(s):  
Thanapon Sutharaphan ◽  
Kumutnart Chanprapaph ◽  
Vasanop Vachiramon
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Case Reports ◽  
Corticosteroid Injection ◽  
Granulomatous Inflammation ◽  
Spontaneous Remission ◽  
Expert Opinions ◽  
Cheilitis Granulomatosa ◽  
Unsuccessful Treatment ◽  
Intralesional Corticosteroid

Cheilitis granulomatosa (CG) is a rare idiopathic condition with painless lip swelling, characterized by non-necrotizing granulomatous inflammation in the absence of other identifiable causes such as Crohn’s disease, sarcoidosis, foreign body reaction, or infection. CG may precede the presentation of Crohn’s disease after long-term follow-up. Spontaneous remission of CG rarely occurs. To date, given the rarity of CG, there is no gold standard treatment. Recommended treatments are supported by small studies, case reports/series, and expert opinions. Glucocorticoids are the first-line therapy in the acute stages of the disease; however, recurrence commonly occurs. Previously, methotrexate (MTX) showed a beneficial effect on orofacial swelling in a case of CG accompanied by Crohn’s disease. We present a patient with CG without Crohn’s disease. He was treated with oral MTX in combination with intralesional corticosteroid injection on one side of the lip. The injected side showed improvement, while lip swelling on the noninjected area remained unchanged after 3 months of treatment. Therefore, CG is refractory to treatment with MTX from our experience. Further studies regarding the optimum dosage of MTX is needed.

scholarly journals Oral Microbiota Composition and Antimicrobial Antibody Response in Patients with Recurrent Aphthous Stomatitis

2019 ◽  
Vol 7 (12) ◽  
pp. 636 ◽  
Author(s):  
Zuzana Stehlikova ◽  
Vojtech Tlaskal ◽  
Natalie Galanova ◽  
Radka Roubalova ◽  
Jakub Kreisinger ◽  
...  
Keyword(s):  
Oral Mucosa ◽  
Serum Levels ◽  
Recurrent Aphthous Stomatitis ◽  
Aphthous Stomatitis ◽  
Common Disease ◽  
Oral Microbiota ◽  
Healthy Controls ◽  
Alpha And Beta Diversity ◽  
Oral Site ◽  
Bacteria And Fungi

Recurrent aphthous stomatitis (RAS) is the most common disease of the oral mucosa, and it has been recently associated with bacterial and fungal dysbiosis. To study this link further, we investigated microbial shifts during RAS manifestation at an ulcer site, in its surroundings, and at an unaffected site, compared with healed mucosa in RAS patients and healthy controls. We sampled microbes from five distinct sites in the oral cavity. The one site with the most pronounced differences in microbial alpha and beta diversity between RAS patients and healthy controls was the lower labial mucosa. Detailed analysis of this particular oral site revealed strict association of the genus Selenomonas with healed mucosa of RAS patients, whereas the class Clostridia and genera Lachnoanaerobaculum, Cardiobacterium, Leptotrichia, and Fusobacterium were associated with the presence of an active ulcer. Furthermore, active ulcers were dominated by Malassezia, which were negatively correlated with Streptococcus and Haemophilus and positively correlated with Porphyromonas species. In addition, RAS patients showed increased serum levels of IgG against Mogibacterium timidum compared with healthy controls. Our study demonstrates that the composition of bacteria and fungi colonizing healthy oral mucosa is changed in active RAS ulcers, and that this alteration persists to some extent even after the ulcer is healed.

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