The oral cavity in Crohn's disease

Authors: Pittock, Drumm, Fleming, McDermott, Imrie, Flint, Bourke

Journal: Journal of Pediatrics

Date: May 2001

Main Topic: Crohn’s Disease

Purpose: To assess the utility of oral examination as part of the diagnosis of patients with Crohn’s disease.

Summary: In this investigation, 48% of newly diagnosed patients with Crohn’s disease had oral lesions. When biopsied, 75% of the lesions contained non-caseating granulomas. No surprises here: “patients with oral CD had more oral symptoms.”

Oral manifestations are common in children, so oral examination can assist in the diagnosis of Crohn’s disease.

Findings:

This was a retrospective chart review over 5 years done at a hospital for sick children. They went back and looked at the presence of oral ulcerations in children who were diagnosed with Crohn’s disease. They then analyzed the date to come up with their findings.

Crohn’s is an inflammatory bowel disease characterized by granulomatous inflammation affecting the GI tract from mouth to anus. The oral lesions look similar to apthous or those in ulcerative colitis, and their presence alone is not diagnostic. Diagnosis depends on clinical presentation and histopathology. A pediatric dental surgeon can be used to identify and biopsy these lesions.

The presence of oral lesions did not correlate with the severity of the disease.

My take: good information to have for differential diagnosis of oral ulcerations.