TRIAD OF PEDIATRIC OROFACIAL GRANULOMATOSIS, CROHN’S DISEASE AND INFLIXIMAB – A SYSTEMATIC REVIEW
Main Article Content
Keywords
Orofacial granulomatosis, Inflammatory bowel disease, Crohn’s disease, infliximab, hypersensitivity, inflammatory disorders
Abstract
Background: Crohn's disease (CD), a kind of inflammatory bowel disease (IBD), is a systemic illness that often affects extraintestinal organs in addition to the gastrointestinal (GI) tract. Up to 24% of IBD patients experience extraintestinal manifestations (EIMs) prior to the development of intestinal symptoms, which can have a significant impact on their quality of life. The rare disorder known as orofacial granulomatosis (OFG) is characterized by the histologic finding of noncaseating granulomas in the oral mucosa and face on tissue biopsy, leading to chronic swelling. Less than 1% of CD patients have OFG, and biopsy is the most reliable way to make the diagnosis. While some view OFG as a separate condition without a systemic granulomatous disorder, others see it as a more comprehensive diagnosis that includes isolated OFG as well as a potential sign of sarcoidosis or CD. OFG frequently has a chronic and deforming course, which makes it very challenging to treat and eventually lowers the quality of life for those who are afflicted. In oral medicine, they are used to treat a number of ailments. For the treatment of complicated oral disorders such as Sjogren's disease, pemphigus vulgaris, and mucous membrane pemphigoid, biologics are increasingly advised. TNF-α inhibitors, such as adalimumab and infliximab, have also been shown to be effective in treating orofacial granulomatosis (OFG) and oral Crohn's disease. Six Nevertheless, little is known about how these substances affect the oral cavity and dental care.
Material and Methods: Major databases such as Medline were explored detailed literature search in resulting in a systematic review pertaining to Effective treatment of pediatric orofacial granulomatosis secondary to Crohn’s disease with infliximab.
Results: Five original research scientific articles dated between 2020 – 2024 pertaining to mentioned topic were highlighted.
Conclusions: As a crucial early marker of underlying Crohn's disease, pediatric orofacial granulomatosis (OFG) requires extensive biopsies, ongoing surveillance, and interdisciplinary cooperation. Biologic therapy using infliximab provides a very effective way to alleviate symptoms and stop long-term structural orofacial damage in extreme situations. By identifying oral symptoms, keeping an eye on patients taking biologics, and working closely with medical specialists to guarantee thorough patient management, dental professionals play a critical role in this care network. Detailed information regarding the Effective treatment of pediatric orofacial granulomatosis secondary to Crohn’s disease with infliximab is discussed in this systematic review.
References
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2.Phillips F, Verstockt B, Sladek M, de Boer N, Katsanos K, Karmiris K, Albshesh A, Erikson C, Bergemalm D, Molnar T, Ellul P. Orofacial granulomatosis associated with Crohn’s disease: a multicentre case series. Journal of Crohn's and Colitis. 2022 Mar 1;16(3):430-5. doi: 10.1093/ecco-jcc/jjab158.
3.Gilmore R, Li Wai Suen CF, Elliott T, De Cruz P, Srinivasan A. Using ustekinumab to treat Crohn’s disease–related orofacial granulomatosis: two birds, one stone. Inflammatory bowel diseases. 2020 Jul 17;26(8):e79-80. doi: 10.1093/ibd/izaa123.
4.Grave B, McCullough M, Wiesenfeld D. Orofacial granulomatosis–a 20‐year review. Oral diseases. 2009 Jan;15(1):46-51. doi: 10.1111/j.1601-0825.2008.01500.x.
5.Campbell H, Escudier M, Patel P, Nunes C, Elliott TR, Barnard K, Shirlaw P, Poate T, Cook R, Milligan P, Brostoff J. Distinguishing orofacial granulomatosis from crohn's disease: two separate disease entities?. Inflammatory bowel diseases. 2011 Oct 1;17(10):2109-15. doi: 10.1002/ibd.21599.
6.Fitzpatrick L, Healy CM, McCartan BE, Flint SR, McCreary CE, Rogers S. Patch testing for food‐associated allergies in orofacial granulomatosis. Journal of oral pathology & medicine. 2011 Jan;40(1):10-3. doi: 10.1111/j.1600-0714.2010.00957.x.
7.Al Johani KA, Moles DR, Hodgson TA, Porter SR, Fedele S. Orofacial granulomatosis: clinical features and long-term outcome of therapy. Journal of the American Academy of Dermatology. 2010 Apr 1;62(4):611-20. doi: 10.1016/j.jaad.2009.03.051.
8.Lourenço SV, Hussein TP, Bologna SB, Sipahi AM, Nico MM. Oral manifestations of inflammatory bowel disease: a review based on the observation of six cases. Journal of the European Academy of Dermatology and Venereology. 2010 Feb;24(2):204-7. doi: 10.1111/j.1468-3083.2009.03304.x.
9.Taibjee SM, Prais L, Foulds IS. Orofacial granulomatosis worsened by chocolate: results of patch testing to ingredients of Cadbury's chocolate. British Journal of Dermatology. 2004 Mar 1;150(3):595-. doi: 10.1046/j.1365-2133.2004.05829.x.
10.Oliver AJ, Rich AM, Reade PC, Varigos GA, Radden BG. Monosodium glutamate-related orofacial granulomatosis: review and case report. Oral surgery, oral medicine, oral pathology. 1991 May 1;71(5):560-4. doi: 10.1016/0030-4220(91)90362-g.
11.Gibson J, Wray D. Human leucocyte antigen typing in orofacial granulomatosis. British Journal of Dermatology. 2000 Nov 1;143(5):1119-21. doi: 10.1046/j.1365-2133.2000.03877.x.
12.Satsangi J, Jewell DP, Rosenberg WM, Bell JI. Genetics of inflammatory bowel disease. Gut. 1994 May;35(5):696. DOI: 10.1136/gut.40.5.572
13.Pryce DW, King CM. Orofacial granulomatosis associated with delayed hypersensitivity to cobalt. Clinical and experimental dermatology. 1990 Sep 1;15(5):384-6. doi: 10.1111/j.1365-2230.1990.tb02123.x.
14.Scully C, Eveson JW. Oral granulomatosis (Leading article). Lancet. 1991;338:20-1.(doi: not available)
15.Alawi F. Granulomatous diseases of the oral tissues: differential diagnosis and update. Dental Clinics. 2005 Jan 1;49(1):203-21. doi: 10.1016/j.cden.2004.07.012.
16.Field EA, Allan RB. Oral ulceration–aetiopathogenesis, clinical diagnosis and management in the gastrointestinal clinic. Alimentary pharmacology & therapeutics. 2003 Nov;18(10):949-62. doi: 10.1046/j.1365-2036.2003.01782.x.
17.Rowland M, Fleming P, Bourke B. Looking in the mouth for Crohn's disease. Inflammatory bowel diseases. 2010 Feb 1;16(2):332-7. doi: 10.1002/ibd.20983.
18.Baniţă M, Pisoschi C, Stănciulescu C, Scrieciu M, Tuculină M, Mercuţ V, Căruntu ID. Idiopathic gingival hypertrophy--a morphological study and a review of literature. Revista Medico-chirurgicala a Societatii de Medici si Naturalisti din Iasi. 2008 Oct 1;112(4):1076-83. PMID: 20209790
19.Gagoh OK, Qureshi RM, Hendrickse MT. Recurrent buccal space abscessesA complication of Crohn’s disease. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 1999 Jul 1;88(1):33-6. doi: 10.1016/s1079-2104(99)70190-3.
20.Farhi D, Cosnes J, Zizi N, Chosidow O, Seksik P, Beaugerie L, Aractingi S, Khosrotehrani K. Significance of erythema nodosum and pyoderma gangrenosum in inflammatory bowel diseases: a cohort study of 2402 patients. Medicine. 2008 Sep 1;87(5):281-93. doi: 10.1097/MD.0b013e318187cc9c.
21.Muhvić-Urek M, Tomac-Stojmenović M, Mijandrušić-Sinčić B. Oral pathology in inflammatory bowel disease. World journal of gastroenterology. 2016 Jul 7;22(25):5655. doi: 10.3748/wjg.v22.i25.5655.
22.Ehlers S. Why does tumor necrosis factor targeted therapy reactivate tuberculosis?. The Journal of Rheumatology Supplement. 2005 Mar 1;74:35-9. PMID: 15742463
23.Saalman R, Mattsson U, Jontell M. Orofacial granulomatosis in childhood—a clinical entity that may indicate Crohn's disease as well as food allergy. Acta paediatrica. 2009 Jul;98(7):1162-7. doi: 10.1111/j.1651-2227.2009.01295.x
24.Ferré MP, Boscá-Watts MM, Pérez MM. Crohn's disease. Medicina Clínica (English Edition). 2018 Jul 13;151(1):26-33. doi: 10.1111/rda.13048.
25.Peña AS. El significado de las mutaciones de CARD15 en la enfermedad de Crohn: La contribución española. Revista Española de Enfermedades Digestivas. 2007 Oct;99(10):563-9.(doi: not available)
26.Rubbino F, Greco L, di Cristofaro A, Gaiani F, Vetrano S, Laghi L, Bonovas S, Piovani D. Journey through Crohn’s disease complication: from fistula formation to future therapies. Journal of Clinical Medicine. 2021 Nov 26;10(23):5548. doi: 10.3390/jcm10235548.
27.Wolters FL, Russel MG, Sijbrandij J, Schouten LJ, Odes S, Riis L, Munkholm P, Bodini P, O’Morain C, Mouzas IA, Tsianos E. Crohn’s disease: increased mortality 10 years after diagnosis in a Europe-wide population based cohort. Gut. 2006 Apr 1;55(4):510-8. doi: 10.1136/gut.2005.072793
28.Mignogna MD, Fedele S, Russo LL, Adamo D, Satriano RA. Effectiveness of small-volume, intralesional, delayed-release triamcinolone injections in orofacial granulomatosis: a pilot study. Journal of the American Academy of Dermatology. 2004 Aug 1;51(2):265-8. doi: 10.1016/s0190-9622(03)00769-2.
29.Casson DH, Eltumi M, Tomlin S, Walker-Smith JA, Murch SH. Topical tacrolimus may be effective in the treatment of oral and perineal Crohn's disease. Gut. 2000 Sep 1;47(3):436-40. doi: 10.1136/gut.47.3.436
30.Elliott T, Campbell H, Escudier M, Poate T, Nunes C, Lomer M, Mentzer A, Patel P, Shirlaw P, Brostoff J, Challacombe S. Experience with anti‐tnf‐α therapy for orofacial granulomatosis. Journal of oral pathology & medicine. 2011 Jan;40(1):14-9. doi: 10.1111/j.1600-0714.2010.00976.x.
31.Vavricka SR, Brun L, Ballabeni P, Pittet V, Vavricka BM, Zeitz J, Rogler G, Schoepfer AM, Swiss IBD Cohort Study Group. Frequency and risk factors for extraintestinal manifestations in the Swiss inflammatory bowel disease cohort. Official journal of the American College of Gastroenterology| ACG. 2011 Jan 1;106(1):110-9. doi: 10.1038/ajg.2010.343.
32.Halevy S, Shalom G, Trattner A, Bodner L. Melkersson-Rosenthal syndrome: a possible association with psoriasis. Journal of the American Academy of Dermatology. 2012 Oct 1;67(4):795-6. doi: 10.1016/j.jaad.2012.04.022.
33.Ramesh V. Orofacial Granulomatosis due to Tuberculosis. Pediatric dermatology. 2009 Jan 1;26(1). doi: 10.1111/j.1525-1470.2008.00840.x.
34.Macaigne G, Harnois F, Boivin JF, Dikov D, Ridoux G, Cheaib S, Chayette C. Crohn's disease revealed by a cheilitis granulomatosa with favorable evolution by perfusions of infliximab: report of a case and review of the literature. Clinics and research in hepatology and gastroenterology. 2011 Feb 1;35(2):147-9. doi: 10.1016/j.clinre.2010.10.001.
35.Tarrant KM, Barclay ML, Frampton CM, Gearry RB. Perianal disease predicts changes in Crohn's disease phenotype—results of a population-based study of inflammatory bowel disease phenotype. Official journal of the American College of Gastroenterology| ACG. 2008 Dec 1;103(12):3082-93. doi: 10.1111/j.1572-0241.2008.02212.x.
36.Luzentales-Simpson M, Pang YC, Zhang A, Sousa JA, Sly LM. Vedolizumab: potential mechanisms of action for reducing pathological inflammation in inflammatory bowel diseases. Frontiers in cell and developmental biology. 2021 Feb 3;9:612830. doi: 10.3389/fcell.2021.612830.
37.Jukema JB, Brandse JF, De Boer NK. Successful treatment of oral Crohn’s disease by ustekinumab. Inflammatory Bowel Diseases. 2020 Jan 7;26(3):e19. doi: 10.1093/ibd/izz321.
38.Joly P, Maho-Vaillant M, Prost-Squarcioni C, Hebert V, Houivet E, Calbo S, Caillot F, Golinski ML, Labeille B, Picard-Dahan C, Paul C. First-line rituximab combined with short-term prednisone versus prednisone alone for the treatment of pemphigus (Ritux 3): a prospective, multicentre, parallel-group, open-label randomised trial. The Lancet. 2017 May 20;389(10083):2031-40. doi: 10.1016/S0140-6736(17)30070-3
39.Bohelay G, Alexandre M, Le Roux-Villet C, Sitbon I, Doan S, Soued I, Shourick J, Rousset L, Mellottee B, Heller M, Lièvre N. Rituximab therapy for mucous membrane pemphigoid: a retrospective monocentric study with long-term follow-up in 109 patients. Frontiers in immunology. 2022 Jun 30;13:915205. doi: 10.3389/fimmu.2022.915205.
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May 01, 2015
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Dr. V. Vasanthakumar. (2015). TRIAD OF PEDIATRIC OROFACIAL GRANULOMATOSIS, CROHN’S DISEASE AND INFLIXIMAB – A SYSTEMATIC REVIEW. Journal of Population Therapeutics and Clinical Pharmacology, 22(3), 352-361. https://doi.org/10.69980/5fs3vn07
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All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
Dr. V. Vasanthakumar. (2015). TRIAD OF PEDIATRIC OROFACIAL GRANULOMATOSIS, CROHN’S DISEASE AND INFLIXIMAB – A SYSTEMATIC REVIEW. Journal of Population Therapeutics and Clinical Pharmacology, 22(3), 352-361. https://doi.org/10.69980/5fs3vn07
