Cargando…
Clinical evidence for allergy in orofacial granulomatosis and inflammatory bowel disease
BACKGROUND: Orofacial granulomatosis (OFG) causes chronic, disfiguring, granulomatous inflammation of the lips and oral mucosa. A proportion of cases have co-existing intestinal Crohn’s disease (CD). The pathogenesis is unknown but has recently been linked to dietary sensitivity. Although allergy ha...
Autores principales: | , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2013
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3751572/ https://www.ncbi.nlm.nih.gov/pubmed/23947721 http://dx.doi.org/10.1186/2045-7022-3-26 |
_version_ | 1782281626789609472 |
---|---|
author | Patel, Pritash Brostoff, Jonathan Campbell, Helen Goel, Rishi M Taylor, Kirstin Ray, Shuvra Lomer, Miranda Escudier, Michael Challacombe, Stephen Spencer, Jo Sanderson, Jeremy |
author_facet | Patel, Pritash Brostoff, Jonathan Campbell, Helen Goel, Rishi M Taylor, Kirstin Ray, Shuvra Lomer, Miranda Escudier, Michael Challacombe, Stephen Spencer, Jo Sanderson, Jeremy |
author_sort | Patel, Pritash |
collection | PubMed |
description | BACKGROUND: Orofacial granulomatosis (OFG) causes chronic, disfiguring, granulomatous inflammation of the lips and oral mucosa. A proportion of cases have co-existing intestinal Crohn’s disease (CD). The pathogenesis is unknown but has recently been linked to dietary sensitivity. Although allergy has been suggested as an aetiological factor in OFG there are few published data to support this link. In this study, we sought clinical evidence of allergy in a series of patients with OFG and compared this to a series of patients with inflammatory bowel disease (IBD) without oral involvement and to population control estimates. METHODS: Prevalence rates of allergy and oral allergy syndrome (OAS) were determined in 88 patients with OFG using questionnaires, skin prick tests, total and specific serum IgE levels. Allergy was also determined in 117 patients with IBD without evidence of oral involvement (79 with CD and 38 with ulcerative colitis (UC)). RESULTS: Prevalence rates of allergy in patients with OFG were significantly greater than general population estimates (82% versus 22% respectively p = <0.0005). Rates of allergy were also greater in those with CD (39%) and, interestingly, highest in those with OFG and concurrent CD (87%). Conversely, whist OAS was common in allergic OFG patients (35%) rates of OAS were significantly less in patients with concomitant CD (10% vs 44% with and without CD respectively p = 0.006). Amongst CD patients, allergy was associated with perianal disease (p = 0.042) but not with ileal, ileocolonic or colonic disease location. Allergy in UC (18%) was comparable to population estimates. CONCLUSION: We provide compelling clinical evidence for the association of allergy with OFG whether occurring alone or in association with CD. The presence of gut CD increases this association but, conversely, reduces the expression of OAS in those with atopy. Interestingly, there is no evidence of increased allergy in UC. |
format | Online Article Text |
id | pubmed-3751572 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-37515722013-08-24 Clinical evidence for allergy in orofacial granulomatosis and inflammatory bowel disease Patel, Pritash Brostoff, Jonathan Campbell, Helen Goel, Rishi M Taylor, Kirstin Ray, Shuvra Lomer, Miranda Escudier, Michael Challacombe, Stephen Spencer, Jo Sanderson, Jeremy Clin Transl Allergy Research BACKGROUND: Orofacial granulomatosis (OFG) causes chronic, disfiguring, granulomatous inflammation of the lips and oral mucosa. A proportion of cases have co-existing intestinal Crohn’s disease (CD). The pathogenesis is unknown but has recently been linked to dietary sensitivity. Although allergy has been suggested as an aetiological factor in OFG there are few published data to support this link. In this study, we sought clinical evidence of allergy in a series of patients with OFG and compared this to a series of patients with inflammatory bowel disease (IBD) without oral involvement and to population control estimates. METHODS: Prevalence rates of allergy and oral allergy syndrome (OAS) were determined in 88 patients with OFG using questionnaires, skin prick tests, total and specific serum IgE levels. Allergy was also determined in 117 patients with IBD without evidence of oral involvement (79 with CD and 38 with ulcerative colitis (UC)). RESULTS: Prevalence rates of allergy in patients with OFG were significantly greater than general population estimates (82% versus 22% respectively p = <0.0005). Rates of allergy were also greater in those with CD (39%) and, interestingly, highest in those with OFG and concurrent CD (87%). Conversely, whist OAS was common in allergic OFG patients (35%) rates of OAS were significantly less in patients with concomitant CD (10% vs 44% with and without CD respectively p = 0.006). Amongst CD patients, allergy was associated with perianal disease (p = 0.042) but not with ileal, ileocolonic or colonic disease location. Allergy in UC (18%) was comparable to population estimates. CONCLUSION: We provide compelling clinical evidence for the association of allergy with OFG whether occurring alone or in association with CD. The presence of gut CD increases this association but, conversely, reduces the expression of OAS in those with atopy. Interestingly, there is no evidence of increased allergy in UC. BioMed Central 2013-08-15 /pmc/articles/PMC3751572/ /pubmed/23947721 http://dx.doi.org/10.1186/2045-7022-3-26 Text en Copyright © 2013 Patel et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Patel, Pritash Brostoff, Jonathan Campbell, Helen Goel, Rishi M Taylor, Kirstin Ray, Shuvra Lomer, Miranda Escudier, Michael Challacombe, Stephen Spencer, Jo Sanderson, Jeremy Clinical evidence for allergy in orofacial granulomatosis and inflammatory bowel disease |
title | Clinical evidence for allergy in orofacial granulomatosis and inflammatory bowel disease |
title_full | Clinical evidence for allergy in orofacial granulomatosis and inflammatory bowel disease |
title_fullStr | Clinical evidence for allergy in orofacial granulomatosis and inflammatory bowel disease |
title_full_unstemmed | Clinical evidence for allergy in orofacial granulomatosis and inflammatory bowel disease |
title_short | Clinical evidence for allergy in orofacial granulomatosis and inflammatory bowel disease |
title_sort | clinical evidence for allergy in orofacial granulomatosis and inflammatory bowel disease |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3751572/ https://www.ncbi.nlm.nih.gov/pubmed/23947721 http://dx.doi.org/10.1186/2045-7022-3-26 |
work_keys_str_mv | AT patelpritash clinicalevidenceforallergyinorofacialgranulomatosisandinflammatoryboweldisease AT brostoffjonathan clinicalevidenceforallergyinorofacialgranulomatosisandinflammatoryboweldisease AT campbellhelen clinicalevidenceforallergyinorofacialgranulomatosisandinflammatoryboweldisease AT goelrishim clinicalevidenceforallergyinorofacialgranulomatosisandinflammatoryboweldisease AT taylorkirstin clinicalevidenceforallergyinorofacialgranulomatosisandinflammatoryboweldisease AT rayshuvra clinicalevidenceforallergyinorofacialgranulomatosisandinflammatoryboweldisease AT lomermiranda clinicalevidenceforallergyinorofacialgranulomatosisandinflammatoryboweldisease AT escudiermichael clinicalevidenceforallergyinorofacialgranulomatosisandinflammatoryboweldisease AT challacombestephen clinicalevidenceforallergyinorofacialgranulomatosisandinflammatoryboweldisease AT spencerjo clinicalevidenceforallergyinorofacialgranulomatosisandinflammatoryboweldisease AT sandersonjeremy clinicalevidenceforallergyinorofacialgranulomatosisandinflammatoryboweldisease |