Celiac sprue in patients with chronic oral mucosal symptoms

Eighty-two consecutive patients with oral mucosal disorders were screened for celiac sprue with serum immunoglobulin A (IgA)-class endomysial and gliadin antibodies. In positive cases the diagnosis of celiac sprue was established by duodenal biopsy. Four patients were positive for endomysial antibodies and 22 for gliadin antibodies. Four (4.9%) patients were found to have celiac sprue: three of them by screening and one was previously diagnosed. Endomysial antibodies were present in all three newly diagnosed patients with celiac sprue, and gliadin antibodies were present in one. Sixteen of 22 patients positive for gliadin antibodies underwent small bowel biopsy, and 15 had normal mucosa. Patients with chronic oral mucosal disorders and a positive endomysial antibody test may suffer from celiac sprue. By contrast, gliadin antibodies were very prevalent even in the absence of celiac sprue.