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.
From the Tampere University Hospital and the Institute of Medical Technology and Medical School, University of Tampere, Finland; and the Institute of Human Nutrition and Food Science, University of Kiel, Germany.
Received June 25, 1997. Sent for revision July 10, 1997. Accepted October 5, 1997.
Supported by a grant from the Medical Research Fund of Tampere University Hospital and the Medical Research Council, the Academy of Finland.
Address correspondence and reprint requests to Dr. Pekka Collin, Medical School, University of Tampere, PO Box 607, FIN-33101 Tampere, Finland.