Table 3.

Studies of celiac disease (CD) in recurrent aphthous stomatitis (RAS) patients

Author, Year	Number of RAS patients with CD / Total RAS patients (%)	Comments
Ferguson et al., 1975	7/35 (20%)	CD diagnosed based on jejunal biopsies.
Wray et al., 1975	5/130 (4%)
Ferguson et al., 1976	8/33 (24%)	CD diagnosed based on jejunal biopsies. Use of a gluten-free diet resulted in complete remission of RAS in these 8 patients.
Wray et al., 1978	20/330 (6%)	Extension of above study. CD was present in 6 of 10 patients who had iron deficiency, 12 of 15 patients with folic acid deficiency and 2 of 11 patients with vitamin B12 deficiency.
Rose et al., 1978	1/26 (4%)	CD diagnosed based on jejunal biopsies. A gluten-free diet did not result in any change in this patient’s mouth ulcers.
Ferguson et al., 1980	2/50 (4%)
Veloso & Saleiro, 1987	4/24 (17%)	In the 4 patients with RAS and biopsy-proven CD, RAS resolved completely upon gluten withdrawal. 0 of 19 non-RAS controls had CD, based on jejunal biopsy.
O’Farrelly et al., 1991	4/10 (40%)	Of 10 RAS patients with normal intestinal biopsies, 4 patients had increased levels of antibodies to gliadin. In 3 of these 4 patients, RAS resolved on a gluten-free diet and recurred on re-challenge.
Jokinen et al., 1998	9/27 (33%)	Of 27 patients suffering from “recurrent oral ulcerations”, 6 had anti-gliadin antibodies and 3 were diagnosed with CD by biopsy.
Biel et al., 2000	1/1 (100%)	Case Report. A 51 year old woman with a 30 year history of painful refractory RAS was diagnosed with CD by duodenal biopsy. Treatment with a gluten-free diet resulted in complete resolution of RAS lesions and no recurrences in a 3 year follow-up.
Nowak et al., 2002	1/20 (5%)	Diagnosis based on anti-endomysial antibodies in the one patient.
Aydemir et al., 2004	2/41 (5%)	The 2 CD patients had positive duodenal biopsy and were both positive for antibodies to gliadin and endomysium. None of 49 (0%) controls were diagnosed with CD.
Olszewska et al., 2006	2/42 (5%)	2 RAS patients were diagnosed with CD based on anti-endomysial antibodies and duodenal biopsies vs. 0 of 42 controls (not statistically significant) In the 2 patients with both RAS and CD, a gluten-free diet resulted in complete resolution of RAS lesions.
da Silva et al., 2008	1/1 (100%)	Case Report. CD was confirmed by small intestine biopsy and circulating antigliadin and anti-endomysium antibodies in a woman with frequent RAS episodes. Topical dexamethasone rinse was effective in resolving RAS lesions; the patient was then put on a gluten-free diet.