“Masks” of celiac disease: a butterfly-shaped enanthema on the oral mucosa as an undescribed marker of the disease
Abstract
Clinical changes in the oral mucosa in patients with celiac disease are common and may be one of the markers of the undiagnosed disease and its atypical forms. In addition to the changes described earlier, the doctor may encounter atypical manifestations that require the exclusion of gluten enteropathy as part of a differential diagnosis. The article describes a clinical case of celiac disease diagnosis in a 10-year-old patient with Shereshevsky–Turner syndrome with complaints of recurrent hard palate enanthema in the form of a butterfly that occurs during the incubation period or in the first days of the onset of acute respiratory infection. The results of laboratory, instrumental, genetic and morphological studies confirmed the presence of gluten enteropathy. Against the background of a gluten-free diet, the recurrence of enanthema was stopped. The described new type of enanthema in a child at risk of developing celiac disease can be considered as another marker of this disease, and therefore it is recommended that all patients with unclear recurrent oral enanthemas be screened for celiac disease in order to make a timely diagnosis and start gluten-free diet therapy.
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