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 20 February 2018

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News

Oro-facial granulomatosis is neither Crohn's nor a new IBD

The most recent issue of Inflammatory Bowel Diseases reports that oro-facial granulomatosis with associated intestinal inflammation may represent a separate entity of inflammation in the gastrointestinal tract in response to an unknown antigen.

News image

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Oro-facial granulomatosis is a rare chronic inflammatory disorder presenting characteristically with lip swelling.

The inflammatory disorder also affects the gingivae, buccal mucosa, floor of mouth, and a number of other sites in the oral cavity.

Histologically, oro-facial granulomatosis resembles Crohn's disease, and a number of patients with Crohn's have oral involvement identical to oro-facial granulomatosis.

However, the exact relationship between oro-facial granulomatosis and Crohn's remains unknown, which Dr Jeremy Sanderson and colleagues explored.

The research team identified 35 patients with oro-facial granulomatosis and no gut symptoms from a combined oral medicine/gastroenterology clinic.

All patients underwent a standardized assessment of the oral cavity and oral mucosal biopsy.

The standardized assessment was necessary to characterize the number of sites affected and the type of inflammation involved.

The researchers also recorded hematological and biochemical parameters of the patients.

Granulomas were present in 64% and colonic abnormalities in 54%
Inflammatory Bowel Diseases

The team reported that all 35 patients underwent ileocolonoscopy and biopsy to assess the presence of coexistent intestinal inflammation.

The researchers detected ileal or colonic abnormalities in 54% of cases.

From gut biopsies, the team noted that granulomas were present in 64% of cases.

The researchers found that an intestinal abnormality was significantly more likely if the age of oro-facial granulomatosis onset was less than 30 years.

Those with more severe oral inflammation were also more likely to have intestinal inflammation.

The research team observed a correlation between the histologic severity of oral inflammation and the histologic severity of gut inflammation.

No relationship was found between any blood parameter and intestinal involvement.

Dr Sanderson's team concluded, “Endoscopic and histologic intestinal abnormalities are common in patients with oro-facial granulomatosis with no gastrointestinal symptoms.”

“Younger patients with oro-facial granulomatosis are more likely to have concomitant intestinal involvement.”

“In these patients, granulomas are more frequent in endoscopic biopsies than reported in patients with documented Crohn's disease.”

“Oro-facial granulomatosis with associated intestinal inflammation may represent a separate entity in which granulomatous inflammation occurs throughout the gastrointestinal tract in response to an unknown antigen or antigens.”

Inflamm Bowel Dis 2005: 11(9): 840-6
24 August 2005

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