Case Report: Exploring the link between severe gingivitis and inflammatory bowel disease in a young patient

Severe gingival inflammation, which is uncommon in pediatric patients, often indicates underlying systemic conditions. Leukemia, autoimmune diseases, and allergic symptoms can cause gingivitis owing to systemic inflammation. Several gastrointestinal diseases, such as inflammatory bowel disease (IBD), can lead to gingival inflammation. We encountered a case of gingivitis in young child with constipation, which may be a symptom of gastrointestinal disease. The case exhibited recurrent gingival erythema and swelling accompanied by a history of constipation. Furthermore, the case exhibited perianal symptoms, such as fissures or abscesses. Upon referral to a pediatrician, blood tests were performed. The white blood cell levels were elevated, suggesting that systemic inflammation was involved. Leukemia was ruled out as a differential diagnosis. Severe gingivitis prompted a pediatrician to perform further invasive examinations, such as endoscopy in the case. Ultimately, the case was diagnosed with Crohn's disease (CD), an IBD. These findings highlight the importance of considering systemic diseases in pediatric patients presenting with atypical or treatment-resistant gingivitis. Early recognition and interdisciplinary collaboration can facilitate prompt diagnosis of IBD and improve patient outcomes. Thus, gingival swelling may serve as a sentinel sign of systemic inflammation in children.