Diagnostic Approach and Management of Food Allergy-Associated Transient Lingual Papillitis: A Case Report

Abstract

Introduction: Transient lingual papillitis (TLP) is a benign, self-limiting inflammation of the tongue's fungiform papillae causing localized swelling, erythema, and discomfort. Although its etiology remains unclear, evidence links TLP to IgE-mediated food allergies. Further clinical documentation is needed to confirm this allergic association and improve diagnostic accuracy.

Objective: This case report describes the diagnosis and management of food allergy-associated TLP, highlighting the role of IgE assessment. It also emphasizes comprehensive dietary history to identify triggers and differentiate TLP from oral allergy syndrome, aiming to improve diagnostic accuracy and preventive strategies.

Case: A 23-year-old male patient presented with complaints of itching and a burning sensation affecting his tongue and lips. The symptoms developed approximately two hours after consuming shrimp. The patient denied any history of alcohol consumption or smoking. He also reported no known drug allergies or systemic diseases. However, his mother had a history of crab allergy.

Outcome: Intraoral examination revealed irregular, well-demarcated erythematous nodules on the upper lip and dorsal tongue. Immunologic evaluation demonstrated elevated total serum IgE levels (355.7 IU/mL), supporting an allergic predisposition. Management included allergen avoidance and a topical anti-inflammatory gel, resulting in clinical improvement within eight days.

Conclusion: This case highlights the potential role of food allergy as a contributing factor in TLP and emphasizes the importance of thorough dietary history and immunologic assessment. Recognition of allergic triggers enables targeted preventive strategies and may reduce recurrence. Further studies are required to clarify the immunopathogenesis and to establish standardized diagnostic and management protocols.