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BMJ Case Reports 2012; doi:10.1136/bcr-2012-006916

Contact allergic gastritis: an underdiagnosed entity?

  1. Cornelia S L Müller
  1. Department of Dermatology, Saarland University Hospital, Homburg/Saar, Germany
  1. Correspondence to Dr Cornelia S L Müller, cornelia.mueller{at}uks.eu

Summary

Only a few cases of contact allergic gastritis in patients with nickel allergy have been reported. We report a case of probable contact-allergic gastritis in a 46-year-old woman. Clinical examination revealed lichenoid mucosal lesions of the gums adjacent to bridges and crowns that had been implanted several weeks back. Since implantation, the patient had suffered from gastrointestinal complaints (including stomach pain). Gastroscopy showed eosinophilic gastritis. Patch testing done under the diagnosis of contact allergic stomatitis showed positive reactions to: gold sodium thiosulphate; manganese (II) chloride; nickel (II) sulphate; palladium chloride; vanadium (III) chloride and zirconium (IV) chloride. The crowns and bridge contained gold, palladium and zirconium chloride, hence they were replaced by titan-based dentition. Shortly after replacing the artificial dentition, all gastrointestinal symptoms resolved spontaneously without further treatment. Delayed-type allergy against the components of artificial dentition seemed to be the cause of gastritis.

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