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Esquivel-Pedraza L, Cicero-Casarrubias A, Fernández-Cuevas L, Chávez-Ramírez M, Milke-García MP, Domínguez-Cherit J, Méndez-Flores S, Guerrero-Manzo VL. Clinical atrophy patterns of filiform papillae of the tongue and their relationship with the serum levels of iron, vitamin B12 and folic acid in patients with systemic diseases. Int J Dermatol 2023. [PMID: 37038250 DOI: 10.1111/ijd.16669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 01/28/2023] [Accepted: 03/14/2023] [Indexed: 04/12/2023]
Abstract
BACKGROUND The purpose of the study was to evaluate the clinical patterns of atrophy of the filiform papillae (FP) of the tongue and their relationship with the serum levels of iron and vitamin B12 among patients with systemic diseases, in a tertiary care center. METHODS A cross-sectional, analytical, research study was designed. A systematic tongue examination was performed to evaluate the presence and clinical patterns of FP atrophy. We collected epidemiologic, clinical, and laboratory data. Statistical analysis included χ2 test, Fisher's exact test, Kruskal-Wallis test, and a logistic regression analysis. RESULTS A total of 87 patients (83.9% females) were included [median age = 55 (range 20-89) years]. Endocrinopathy (60.9%) was the most frequent comorbidity. We found atrophy of the FP in 90.8% of the patients; the atrophy was mild in 83.5% of the cases, and severe in 16.5%. The most common atrophic patterns were as follows: focalized in 64 (73.6%) cases, "U"-shaped pattern in 60 (69%), and generalized in 30 (34.5%). Geographic tongue and median rhomboid glossitis were observed in 12 (13.8%) and 11 (12.6%) subjects, respectively. Lower titers of serum iron were detected in cases with focal (median = 71 vs. 110 mcg/dl) and generalized (median = 55 vs. 78 mcg/dl) FP atrophy (P = 0.03 and P = 0.009, respectively), than their counterparts. The presence of symptomatology was related to the focal pattern of atrophy (P = 0.038). CONCLUSIONS A high frequency of filiform papillary atrophy of the tongue was observed in patients with comorbidities. Some atrophic patterns of the tongue were significantly associated with certain medical conditions.
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Affiliation(s)
- Lilly Esquivel-Pedraza
- Dermatology Department, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico City, Mexico
- Research & Educational Doctoral Program, Universidad Centro Panamericano de Estudios Superiores, Zitácuaro, Michoacán, Mexico
| | - Alba Cicero-Casarrubias
- Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico City, Mexico
| | - Laura Fernández-Cuevas
- Oral Pathology Department, Centro Dermatológico "Dr. Ladislao de la Pascua", Mexico City, Mexico
| | - Margarita Chávez-Ramírez
- Nutrition Division, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico City, Mexico
| | - María P Milke-García
- Nutrition Division, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico City, Mexico
| | - Judith Domínguez-Cherit
- Dermatology Department, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico City, Mexico
| | - Silvia Méndez-Flores
- Dermatology Department, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico City, Mexico
| | - Víctor L Guerrero-Manzo
- Research & Educational Doctoral Program, Universidad Centro Panamericano de Estudios Superiores, Zitácuaro, Michoacán, Mexico
- Centro de Actualización del Magisterio en Michoacán, Morelia, Michoacán, Mexico
- Hospital Regional ISSSTE, Morelia, Michoacán, Mexico
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Wu YH, Lee YP, Chang JYF, Wang YP, Chiang CP, Sun A. High frequencies of vitamin B12 and folic acid deficiencies and hyperhomocysteinemia in Taiwanese male patients with oral submucous fibrosis. J Dent Sci 2023; 18:407-413. [PMID: 36643223 PMCID: PMC9831841 DOI: 10.1016/j.jds.2022.10.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 10/21/2022] [Indexed: 11/09/2022] Open
Abstract
Background /purpose: Oral submucous fibrosis (OSF) is a betel quid chewing-caused oral mucosal disease with progressive collagen deposition. This study evaluated whether Taiwanese male OSF patients had high frequencies of vitamin B12 and folic acid deficiencies, hyperhomocysteinemia, and serum gastric parietal cell antibody (GPCA) positivity. Materials and methods The blood hemoglobin (Hb), serum iron, vitamin B12, folic acid, homocysteine, and GPCA concentrations in 62 male OSF patients were measured and compared with the corresponding data in 124 age-matched male healthy control subjects. Results We found that 5 (8.1%), 12 (19.4%), 32 (51.6%), 31 (50.0%), 22 (35.5%), and 6 (9.7%) of the 62 male OSF patients had Hb (<13 g/dL), iron (≤70 μg/dL), vitamin B12 (≤450 pg/mL), and folic acid (≤6 ng/mL) deficiencies, hyperhomocysteinemia (>12 μM), and serum GPCA positivity, respectively. Furthermore, OSF patients had significantly higher frequencies of Hb (P = 0.006), vitamin B12 (P < 0.001), and folic acid (P < 0.001) deficiencies, hyperhomocysteinemia (P < 0.001), and serum GPCA positivity (P = 0.030) than 124 healthy control subjects. Of the 22 OSF patients with hyperhomocysteinemia, 4 had vitamin B12 deficiency only, 7 had folic acid deficiency only, and 11 had both vitamin B12 and folic acid deficiencies. Conclusion We conclude that Taiwanese male OSF patients have high frequencies of vitamin B12 and folic acid deficiencies, hyperhomocysteinemia, and serum GPCA positivity. The hyperhomocysteinemia in our OSF patients is predominantly due to deficiencies of either vitamin B12 or folic acid or both.
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Affiliation(s)
- Yu-Hsueh Wu
- Department of Stomatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan,Institute of Oral Medicine, School of Dentistry, National Cheng Kung University, Tainan, Taiwan
| | - Yi-Pang Lee
- Department of Dentistry, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Julia Yu-Fong Chang
- Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan,Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan,Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan
| | - Yi-Ping Wang
- Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan,Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan,Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan
| | - Chun-Pin Chiang
- Department of Dentistry, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan,Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan,Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan,Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan,Corresponding author. Department of Dentistry, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No. 707, Section 3, Chung-Yang Road, Hualien 970, Taiwan.
| | - Andy Sun
- Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan,Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan,Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan,Corresponding author. Department of Dentistry, National Taiwan University Hospital, No. 1, Chang-Te Street, Taipei 10048, Taiwan.
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Higher frequencies of anemia, vitamin B12 deficiency, and gastric parietal cell antibody positivity in folic acid-deficient Taiwanese male oral submucous fibrosis patients. J Dent Sci 2023; 18:801-807. [PMID: 37021251 PMCID: PMC10068482 DOI: 10.1016/j.jds.2023.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 01/17/2023] [Indexed: 01/30/2023] Open
Abstract
Background/purpose Oral submucous fibrosis (OSF) is a progressive fibrotic oral mucosal disease associated with betel quid chewing. This study evaluated whether Taiwanese male OSF patients with folic acid (FA) deficiency (the serum FA level ≤6 ng/mL, so-called FA-deficient OSF patients) had high frequencies of blood hemoglobin (Hb) and serum iron and vitamin B12 deficiencies, and serum gastric parietal cell antibody (GPCA) positivity. Materials and methods The blood Hb and serum iron, vitamin B12, FA, and GPCA concentrations in 59 Taiwanese male FA-deficient OSF patients were measured and compared with the corresponding data in 118 age-matched healthy male control subjects. Results We found that 3 (5.1%), 35 (59.3%), and 7 (11.9%) of the 59 FA-deficient OSF patients had blood Hb (<13 g/dL) and serum vitamin B12 (≤450 pg/mL) deficiencies, and serum GPCA positivity, respectively. Furthermore, 59 FA-deficient OSF patients had significantly higher frequencies of serum vitamin B12 deficiency and serum GPCA positivity than 118 healthy control subjects (all P-values <0.05). Of the 3 anemic FA-deficient OSF patients, one had macrocytic anemia and the other two had thalassemia trait-induced anemia. Conclusion We conclude that Taiwanese male FA-deficient OSF patients have high frequencies of serum vitamin B12 deficiency and GPCA positivity than healthy control subjects. The vitamin B12 and FA deficiencies in FA-deficient OSF patients are more likely due to OSF symptoms and signs-caused insufficient intake, difficulty in chewing and swallowing, and malabsorption of food fragment-bound vitamin B12 and FA rather than the GPCA positivity in these OSF patients.
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Higher frequencies of anemia, hematinic deficiencies, and gastric parietal cell antibody positivity in vitamin B12-deficient Taiwanese male oral submucous fibrosis patients. J Dent Sci 2023; 18:367-373. [PMID: 36643275 PMCID: PMC9831799 DOI: 10.1016/j.jds.2022.10.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 10/19/2022] [Indexed: 11/21/2022] Open
Abstract
Abstract Background/purpose Oral submucous fibrosis (OSF) is a progressive fibrotic oral mucosal disease associated with betel quid chewing. This study evaluated whether Taiwanese male OSF patients with vitamin B12 deficiency (the serum vitamin B12 level ≤ 450 pg/mL, B12-deficient OSF patients) had high frequencies of blood hemoglobin (Hb) and serum iron and folic acid deficiencies, and serum gastric parietal cell antibody (GPCA) positivity. Materials and methods The blood Hb and serum iron, vitamin B12, folic acid, and GPCA concentrations in 66 Taiwanese male B12-deficient OSF patients were measured and compared with the corresponding data in 132 age-matched healthy male control subjects. Results We found that 6 (9.1%), 19 (28.8%), 35 (53.0%), and 9 (13.6%) of the 66 B12-deficient OSF patients had blood Hb (<13 g/dL) and serum iron (≤70 μg/dL), and folic acid (≤6 ng/mL) deficiencies, and serum GPCA positivity, respectively. Furthermore, 66 OSF patients had significantly higher frequencies of blood Hb and serum iron and folic acid deficiencies, and serum GPCA positivity than 132 healthy control subjects (all P-values < 0.05). Of the 6 anemic B12-deficient OSF patients, one had macrocytic anemia, two normocytic anemia, and three thalassemia trait-induced anemia. Conclusion Taiwanese male B12-deficient OSF patients have high frequencies of blood Hb, serum iron and folic acid deficiencies, and serum GPCA positivity. The anemia and hematinic deficiencies in B12-deficient OSF patients are likely due to OSF symptoms and signs-caused insufficient intake, poor chewing, and malabsorption of hematinic elements from ingested food stuffs rather than the GPCA positivity.
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Wu YH, Wu YC, Yu-Fong Chang J, Lee YP, Chiang CP, Sun A. Significantly lower mean serum vitamin B12 and folic acid levels and a significantly higher frequency of serum iron deficiency in younger than in older atrophic glossitis patients. J Dent Sci 2022; 17:1487-1493. [PMID: 36299347 PMCID: PMC9588847 DOI: 10.1016/j.jds.2022.05.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Indexed: 12/31/2022] Open
Abstract
Background/purpose : Our previous study found that 19.0%, 16.9%, 5.3%, 2.3%, and 11.9% of 1064 atrophic glossitis (AG) patients have anemia, serum iron, vitamin B12, and folic acid deficiencies, and hyperhomocysteinemia, respectively. This study mainly evaluated the anemia, hematinic deficiencies, and hyperhomocysteinemia in 224 younger (≤50 years old) and 840 older (>50 years old) AG patients. Materials and methods The blood hemoglobin (Hb) and serum iron, vitamin B12, folic acid, and homocysteine levels in 224 younger and 840 older AG patients were measured and compared with the corresponding levels in 112 younger (≤50 years old) and 420 older (>50 years old) healthy control subjects (HCSs), respectively. Results We found that 224 younger AG patients had significantly lower mean blood Hb and serum iron levels than 112 younger HCSs. Moreover, 840 older AG patients had significantly lower mean blood Hb and serum iron levels and a significantly higher mean serum homocysteine level than 420 older HCSs. In addition, 224 younger AG patients had significantly lower mean serum vitamin B12 and folic acid levels, a lower mean serum homocysteine level (marginal significance, P = 0.056), a significantly higher frequency of serum iron deficiency, and a significantly lower frequency of hyperhomocysteinemia than 840 older AG patients. Conclusion The younger AG patients do have significantly lower mean serum vitamin B12 and folic acid levels, a significantly higher frequency of serum iron deficiency, and a significantly lower frequency of hyperhomocysteinemia than the older AG patients.
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Affiliation(s)
- Yu-Hsueh Wu
- Department of Stomatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Institute of Oral Medicine, School of Dentistry, National Cheng Kung University, Tainan, Taiwan
| | - Yang-Che Wu
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Dentistry, Taipei Medical University-Shuang Ho Hospital, Ministry of Health and Welfare, New Taipei City, Taiwan
| | - Julia Yu-Fong Chang
- Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
- Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan
| | - Yi-Pang Lee
- Department of Dentistry, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Chun-Pin Chiang
- Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
- Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan
- Department of Dentistry, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
- Corresponding author. Department of Dentistry, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No. 707, Section 3, Chung-Yang Road, Hualien 970, Taiwan.
| | - Andy Sun
- Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
- Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan
- Corresponding author. Department of Dentistry, National Taiwan University Hospital, No. 1, Chang-Te Street, Taipei 10048, Taiwan.
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Wu YH, Wu YC, Chang JYF, Lee YP, Chiang CP, Sun A. Significantly higher frequencies of macrocytosis, anemia, serum vitamin B12 and folic acid deficiencies, and hyperhomocysteinemia in male than in female atrophic glossitis patients. J Dent Sci 2022; 17:1371-1377. [PMID: 35784143 PMCID: PMC9236945 DOI: 10.1016/j.jds.2022.05.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 05/16/2022] [Indexed: 12/31/2022] Open
Abstract
Background/purpose Our previous study found that 19.0%, 16.9%, 5.3%, 2.3%, 11.9%, and 26.7% of 1064 atrophic glossitis (AG) patients have anemia, serum iron, vitamin B12, and folic acid deficiencies, hyperhomocysteinemia, and serum gastric parietal cell antibody (GPCA) positivity, respectively. This study evaluated the anemia, hematinic deficiencies, and hyperhomocysteinemia in 150 male and 914 female AG patients. Materials and methods The blood hemoglobin (Hb) and serum iron, vitamin B12, folic acid, homocysteine, GPCA levels in 150 male and 914 female AG patients were measured and compared with the corresponding levels in 75 male and 457 female healthy control subjects (HCSs), respectively. Results We found that 150 male AG patients had significantly lower mean blood Hb, serum iron, vitamin B12, and folic acid levels, and significantly higher mean serum homocysteine levels than 75 male HCSs. Moreover, 914 female AG patients had significantly lower mean blood Hb and serum iron levels and significantly higher mean serum homocysteine level than 457 female HCSs. In addition, 150 male AG patients had significantly higher mean blood Hb and serum homocysteine levels, significantly lower mean serum vitamin B12 and folic acid levels, and significantly higher frequencies of Hb, vitamin B12, and folic acid deficiency and hyperhomocysteinemia than 914 female AG patients. Conclusion The male AG patients do have significantly higher mean blood Hb and serum homocysteine levels, significantly lower mean serum vitamin B12 and folic acid levels, and significantly higher frequencies of Hb, vitamin B12, and folic acid deficiencies and hyperhomocysteinemia than the female AG patients.
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Anemia, hematinic deficiencies, and hyperhomocysteinemia in younger and older burning mouth syndrome patients. J Dent Sci 2022; 17:1144-1150. [PMID: 35784130 PMCID: PMC9236946 DOI: 10.1016/j.jds.2022.02.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Indexed: 12/31/2022] Open
Abstract
Abstract Background/purpose Our previous study found that 19.8%, 16.2%, 4.8%, 2.3%, and 19.2% of 884 burning mouth syndrome (BMS) patients have anemia, serum iron, vitamin B12, and folic acid deficiencies, and hyperhomocysteinemia, respectively. This study mainly evaluated the anemia, hematinic deficiencies, and hyperhomocysteinemia in 272 younger (≤50 years old) and 612 older (>50 years old) BMS patients. Materials and methods The blood hemoglobin (Hb) and serum iron, vitamin B12, folic acid, and homocysteine levels in 272 younger and 612 older BMS patients were measured and compared with the corresponding levels in 136 younger (≤50 years old) and 306 older (>50 years old) healthy control subjects (HCSs), respectively. Results We found that 272 younger BMS patients had significantly lower mean blood Hb and serum iron, vitamin B12, and folic acid levels than 136 younger HCSs. Moreover, 612 older BMS patients had significantly lower mean blood Hb, and serum iron and vitamin B12 levels and significantly higher mean serum homocysteine level than 306 older HCSs. In addition, 272 younger BMS patients had higher mean blood Hb level (marginal significance, P = 0.056), significantly lower mean serum vitamin B12 and folic acid levels, and significantly higher frequencies of iron and folic acid deficiencies than 612 older BMS patients. Conclusion The younger BMS patients do have higher mean blood Hb level, significantly lower mean serum vitamin B12 and folic acid levels, and significantly higher frequencies of serum iron and folic acid deficiencies than the older BMS patients.
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Jin YT, Wu YH, Wu YC, Yu-Fong Chang J, Chiang CP, Sun A. Higher gastric parietal cell antibody titer significantly increases the frequencies of macrocytosis, serum vitamin B12 deficiency, and hyperhomocysteinemia in patients with burning mouth syndrome. J Dent Sci 2022; 17:57-62. [PMID: 35028020 PMCID: PMC8740097 DOI: 10.1016/j.jds.2021.08.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND/PURPOSE Our previous study found 109 gastric parietal cell antibody (GPCA)-positive burning mouth syndrome (BMS) patients (so-called GPCA+BMS patients in this study) in a group of 884 BMS patients. This study evaluated whether high-titer (GPCA titer ≥ 160) GPCA+BMS patients had greater frequencies of macrocytosis, anemia, serum iron and vitamin B12 deficiencies, and hyperhomocysteinemia than low-titer (GPCA titer < 160) GPCA+BMS patients or 442 healthy control subjects. MATERIALS AND METHODS Complete blood count, serum iron, vitamin B12, folic acid, homocysteine, and GPCA levels in 42 high-titer GPCA+BMS patients, 67 low-titer GPCA+BMS patients, and 442 healthy control subjects were measured and compared. RESULTS We found that 33.3%, 38.1%, 19.0%, 33.3%, 2.4%, and 57.1% of 42 high-titer GPCA+BMS patients and 10.4%, 25.4%, 14.9%, 6.0%, 1.5%, and 11.9% of 67 low-titer GPCA+BMS patients were diagnosed as having macrocytosis, blood hemoglobin, iron, vitamin B12, and folic acid deficiencies, and hyperhomocysteinemia, respectively. Moreover, both 42 high-titer and 67 low-titer GPCA+BMS patients had significantly greater frequencies of macrocytosis, blood hemoglobin, serum iron and vitamin B12 deficiencies, and hyperhomocysteinemia than 442 healthy control subjects (all P-values < 0.001). In addition, 42 high-titer GPCA+BMS patients also had greater frequencies of macrocytosis, serum vitamin B12 deficiency, and hyperhomocysteinemia than 67 low-titer GPCA+BMS patients (all P-values < 0.01). CONCLUSION The high-titer GPCA+BMS patients have significantly greater frequencies of macrocytosis, anemia, serum iron and vitamin B12 deficiencies, and hyperhomocysteinemia than healthy control subjects and significantly greater frequencies of macrocytosis, serum vitamin B12 deficiency, and hyperhomocysteinemia than low-titer GPCA+BMS patients.
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Affiliation(s)
- Ying-Tai Jin
- Department of Pathology, Taiwan Adventist Hospital, Taipei, Taiwan.,Department of Pathology, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Yu-Hsueh Wu
- Department of Stomatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Institute of Oral Medicine, School of Dentistry, National Cheng Kung University, Tainan, Taiwan
| | - Yang-Che Wu
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan.,Department of Dentistry, Taipei Medical University-Shuang Ho Hospital, Ministry of Health and Welfare, New Taipei City, Taiwan
| | - Julia Yu-Fong Chang
- Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.,Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan.,Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan
| | - Chun-Pin Chiang
- Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.,Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan.,Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan.,Department of Dentistry, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Andy Sun
- Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.,Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan.,Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan
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Wu YH, Jin YT, Wu YC, Yu-Fong Chang J, Chiang CP, Sun A. Anemia, hematinic deficiencies, and hyperhomocysteinemia in male and female burning mouth syndrome patients. J Dent Sci 2021; 17:935-941. [PMID: 35756793 PMCID: PMC9201654 DOI: 10.1016/j.jds.2021.11.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Indexed: 12/31/2022] Open
Abstract
Background/purpose Our previous study found that 19.8%, 16.2%, 4.8%, 2.3%, 19.2%, and 12.3% of 884 burning mouth syndrome (BMS) patients have anemia, serum iron, vitamin B12, and folic acid deficiencies, hyperhomocysteinemia, and serum gastric parietal cell antibody (GPCA) positivity, respectively. This study mainly evaluated the anemia, hematinic deficiencies, and hyperhomocysteinemia in 212 male and 672 female BMS patients. Materials and methods The blood hemoglobin (Hb) and serum iron, vitamin B12, folic acid, homocysteine, GPCA levels in 212 male and 672 female BMS patients were measured and compared with the corresponding levels in 106 male and 336 female healthy control subjects, respectively. Results We found that 212 male BMS patients had significantly lower mean blood Hb, serum iron, vitamin B12, and folic acid levels and significantly higher mean serum homocysteine levels than 106 male healthy control subjects. Moreover, 672 female BMS patients had significantly lower mean blood Hb and serum iron levels and significantly higher mean serum homocysteine level than 336 female healthy control subjects. In addition, 212 male BMS patients had significantly higher mean blood Hb and serum homocysteine levels, significantly lower mean serum vitamin B12 and folic acid levels, and significantly higher frequencies of folic acid deficiency and hyperhomocysteinemis than 672 female BMS patients. Conclusion The male BMS patients do have significantly higher mean blood Hb and serum homocysteine levels, significantly lower mean serum vitamin B12 and folic acid levels, and significantly higher frequencies of folic acid deficiency and hyperhomocysteinemis than the female BMS patients.
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Jin YT, Wu YH, Wu YC, Yu-Fong Chang J, Chiang CP, Sun A. Anemia, hematinic deficiencies, and hyperhomocysteinemia in serum gastric parietal cell antibody-positive burning mouth syndrome patients without serum thyroid autoantibodies. J Dent Sci 2021; 16:1110-1116. [PMID: 34484577 PMCID: PMC8403879 DOI: 10.1016/j.jds.2021.05.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Indexed: 11/26/2022] Open
Abstract
Background/purpose Our previous study found that 70 of 884 burning mouth syndrome (BMS) patients have serum gastric parietal cell antibody (GPCA) positivity but without thyroglobulin antibody (TGA) and thyroid microsomal antibody (TMA) (so-called GPCA+TGAˉTMAˉBMS patients). This study assessed whether these 70 GPCA+TGAˉTMAˉBMS patients had significantly higher frequencies of macrocytosis, anemia, hematinic deficiencies, and hyperhomocysteinemia than 553 GPCA-negative, TGA-negative, and TMA-negative BMS (GPCAˉTGAˉTMAˉBMS) patients or 442 healthy control subjects. Materials and methods Complete blood count, serum iron, vitamin B12, folic acid, homocysteine, GPCA, TGA, and TMA levels in 70 GPCA+TGAˉTMAˉBMS patients, 553 GPCAˉTGAˉTMAˉBMS patients, and 442 healthy control subjects were measured and compared. Results We found that 15.7%, 28.6%, 20.0%, 11.4%, 2.9%, and 25.7% of 70 GPCA+TGAˉTMAˉBMS patients and 3.8%, 17.7%, 15.9%, 3.8%, 2.7%, and 20.1% of 553 GPCAˉTGAˉTMAˉBMS patients had macrocytosis, blood hemoglobin, iron, vitamin B12, and folic acid deficiencies, and hyperhomocysteinemia, respectively. Moreover, both 70 GPCA+TGAˉTMAˉBMS patients and 553 GPCAˉTGAˉTMAˉBMS patients had significantly greater frequencies of macrocytosis, blood hemoglobin, serum iron, vitamin B12, and folic acid deficiencies, and hyperhomocysteinemia than 442 healthy control subjects (all P-values < 0.05). In addition, 70 GPCA+TGAˉTMAˉBMS patients also had greater frequencies of macrocytosis, anemia, serum vitamin B12 deficiency, and hyperhomocysteinemia than 553 GPCAˉTGAˉTMAˉBMS patients (all P-values < 0.05). Conclusion The GPCA + TGAˉTMAˉBMS patients have significantly greater frequencies of macrocytosis, anemia, serum iron, vitamin B12, and folic acid deficiencies, and hyperhomocysteinemia than healthy control subjects and significantly greater frequencies of macrocytosis, anemia, serum vitamin B12 deficiency, and hyperhomocysteinemia than GPCAˉTGAˉTMAˉBMS patients.
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Affiliation(s)
- Ying-Tai Jin
- Department of Pathology, Taiwan Adventist Hospital, Taipei, Taiwan.,Department of Pathology, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Yu-Hsueh Wu
- Department of Stomatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Institute of Oral Medicine, School of Dentistry, National Cheng Kung University, Tainan, Taiwan
| | - Yang-Che Wu
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan.,Department of Dentistry, Taipei Medical University-Shuang Ho Hospital, Ministry of Health and Welfare, New Taipei City, Taiwan
| | - Julia Yu-Fong Chang
- Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.,Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan.,Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan
| | - Chun-Pin Chiang
- Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.,Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan.,Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan.,Department of Dentistry, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Andy Sun
- Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.,Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan.,Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan
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11
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Lee YP, Loh CH, Hwang MJ, Lin CP. Vitamin B12 deficiency and anemia in 140 Taiwanese female lacto-vegetarians. J Formos Med Assoc 2021; 120:2003-2009. [PMID: 33906782 DOI: 10.1016/j.jfma.2021.04.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 04/04/2021] [Accepted: 04/08/2021] [Indexed: 10/21/2022] Open
Abstract
BACKGROUND/PURPOSE Lacto-vegetarians (LVs) tend to have vitamin B12 deficiency (B12D). This study assessed whether 140 female LVs, including 16 B12D/LVs and 124 non-B12D/LVs, had significantly higher frequencies of microcytosis, macrocytosis, and of blood hemoglobin (Hb), red blood cell (RBC), and serum vitamin B12 deficiencies than 140 healthy control subjects (HCSs). METHODS The complete blood count and serum vitamin B12 level in 140 female LVs and 140 female HCSs were measured and compared. RESULTS We found that 8.6%, 4.3%, 22.9%, 20.0%, and 11.4% of 140 LVs had microcytosis, macrocytosis, and blood Hb, RBC, and serum vitamin B12 deficiencies, respectively. The 140 LVs, 16 B12D/LVs, and 124 non-B12D/LVs had significantly higher frequencies of microcytosis as well as blood Hb and RBC deficiencies than 140 HCSs (all P-values < 0.005). Moreover, both 140 LVs and 124 non-B12D/LVs had significantly higher frequencies of macrocytosis than 140 HCSs. In this study, 32 (22.9%) of 140 LVs including 5 B12D/LVs and 27 non-B12D/LVs had anemia. Of the 5 anemic B12D/LVs, three had normocytic anemia, one had iron deficiency anemia (IDA), and one had thalassemia trait-induced anemia. Moreover, of the 27 anemic non-B12D/LVs, 18 had normocytic anemia, one had IDA, one had thalassemia trait-induced anemia, and 7 had microcytic anemia other than IDA and thalassemia trait-induced anemia. CONCLUSION LVs have significantly higher frequencies of microcytosis, macrocytosis, blood Hb, RBC, and serum vitamin B12 deficiencies than HCSs. Normocytic and microcytic anemias are the two most common types of anemia in our LVs.
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Affiliation(s)
- Yi-Pang Lee
- Department of Dentistry, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Ching-Hui Loh
- Department of Geriatrics and Gerontology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Ming-Jay Hwang
- Department of Dentistry, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan; Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.
| | - Chun-Pin Lin
- Department of Dentistry, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan; Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan; School of Dentistry and Graduate Institute of Clinical Dentistry, National Taiwan University, Taipei, Taiwan.
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12
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Jin YT, Wu YC, Wu YH, Chang JYF, Chiang CP, Sun A. Anemia, hematinic deficiencies, hyperhomocysteinemia, and gastric parietal cell antibody positivity in burning mouth syndrome patients with or without microcytosis. J Dent Sci 2021; 16:608-613. [PMID: 33854709 PMCID: PMC8025219 DOI: 10.1016/j.jds.2020.12.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Indexed: 12/31/2022] Open
Abstract
Background/purpose Microcytosis is defined as having mean corpuscular volume <80 fL. This study evaluated whether 68 burning mouth syndrome (BMS) patients with microcytosis and 816 BMS patients without microcytosis had higher frequencies of anemia, hematinic deficiencies, hyperhomocysteinemia, and serum gastric parietal cell antibody (GPCA) positivity than 442 healthy control subjects. Materials and methods Complete blood count and serum iron, vitamin B12, folic acid, homocysteine, and GPCA levels in 68 BMS patients with microcytosis, 816 BMS patients without microcytosis, and 442 healthy control subjects were measured and compared. Results We found that 73.5%, 44.1%, 4.4%, 2.9%, 13.2%, and 10.3% of 68 BMS patients with microcytosis and 15.3%, 13.8%, 4.8%, 2.2%, 19.7%, and 12.5% of 816 BMS patients without microcytosis had blood hemoglobin, iron, vitamin B12, and folic acid deficiencies, hyperhomocysteinemia, and serum GPCA positivity, respectively. Both 68 BMS patients with microcytosis and 816 BMS patients without microcytosis had significantly higher frequencies of blood hemoglobin, iron, vitamin B12, and folic acid deficiencies, hyperhomocysteinemia, and serum GPCA positivity than 442 healthy control subjects (all P-values < 0.05). Moreover, 68 BMS patients with microcytosis had significantly higher frequencies of blood hemoglobin and iron deficiencies than 816 BMS patients without microcytosis. Conclusion There are significantly higher frequencies of anemia, serum iron, vitamin B12, and folic acid deficiencies, hyperhomocysteinemia, and serum GPCA positivity in BMS patients with or without microcytosis than in healthy control subjects. BMS patients with microcytosis have significantly higher frequencies of blood hemoglobin and iron deficiencies than BMS patients without microcytosis.
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Affiliation(s)
- Ying-Tai Jin
- Department of Pathology, Taiwan Adventist Hospital, Taipei, Taiwan.,Department of Pathology, National Cheng-Kung University Hospital, Tainan, Taiwan
| | - Yang-Che Wu
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan.,Department of Dentistry, Taipei Medical University-Shuang Ho Hospital, Ministry of Health and Welfare, New Taipei City, Taiwan
| | - Yu-Hsueh Wu
- Department of Stomatology, National Cheng Kung University Hospital, Tainan, Taiwan.,Institute of Oral Medicine, School of Dentistry, National Cheng Kung University, Tainan, Taiwan
| | - Julia Yu-Fong Chang
- Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.,Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan.,Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan
| | - Chun-Pin Chiang
- Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.,Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan.,Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan.,Department of Dentistry, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Andy Sun
- Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.,Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan.,Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan
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13
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Chiang ML, Wu YH, Chang JYF, Wang YP, Wu YC, Sun A. Anemia, hematinic deficiencies, and hyperhomocysteinemia in gastric parietal cell antibody-positive and -negative burning mouth syndrome patients. J Formos Med Assoc 2020; 120:819-826. [PMID: 32888843 DOI: 10.1016/j.jfma.2020.08.032] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 08/19/2020] [Accepted: 08/21/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND/PURPOSE Our previous study found the serum gastric parietal cell antibody (GPCA) positivity in 12.3% of burning mouth syndrome (BMS) patients. This study assessed whether GPCA-positive BMS (GPCA+BMS) patients had significantly higher frequencies of macrocytosis, anemia, hematinic deficiencies, and hyperhomocysteinemia than healthy control subjects or GPCA-negative BMS (GPCA-BMS) patients. METHODS The mean corpuscular volume, blood hemoglobin (Hb), and serum iron, vitamin B12, folic acid, homocysteine, and GPCA levels were measured and compared between any two of three groups of 109 GPCA+BMS patients, 775 GPCA-BMS patients, and 442 healthy control subjects. RESULTS We found that 109 GPCA+BMS patients had significantly higher frequencies of macrocytosis, blood Hb and serum iron and vitamin B12 deficiencies, and hyperhomocysteinemia than 442 healthy control subjects (all P-values < 0.001) and significantly higher frequencies of macrocytosis, blood Hb and serum vitamin B12 deficiencies, and hyperhomocysteinemia than 775 GPCA-BMS patients (all P-values < 0.01). Moreover, 775 GPCA-BMS patients had significantly higher frequencies of macrocytosis, blood Hb and serum iron, vitamin B12, and folic acid deficiencies, and hyperhomocysteinemia than 442 healthy control subjects (all P-values < 0.005). Pernicious anemia (45.5%) and normocytic anemia (24.2%) were the two most common types of anemia in 33 anemic GPCA+BMS patients. Moreover, normocytic anemia (61.3%), thalassemia trait-induced anemia (15.5%), and iron deficiency anemia (14.1%) were the three most common types of anemia in 142 anemic GPCA-BMS patients. CONCLUSION GPCA+BMS patients have significantly higher frequencies of macrocytosis, blood Hb and serum vitamin B12 deficiencies, and hyperhomocysteinemia than healthy control subjects or GPCA-BMS patients.
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Affiliation(s)
- Meng-Ling Chiang
- Department of Pediatric Dentistry, Chang Gung Memorial Hospital, Taipei, Taiwan; Department of Oral Pathology and Oral Diagnosis, Chang Gung Memorial Hospital, Taipei, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yu-Hsueh Wu
- Department of Dentistry, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan
| | - Julia Yu-Fong Chang
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan; Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan; Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan
| | - Yi-Ping Wang
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan; Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan; Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan
| | - Yang-Che Wu
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan; Department of Dentistry, Taipei Medical University-Shuang Ho Hospital, Ministry of Health and Welfare, New Taipei City, Taiwan
| | - Andy Sun
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan; Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.
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Hematinic deficiencies, hyperhomocysteinemia, and gastric parietal cell antibody positivity in atrophic glossitis patients with normocytosis. J Formos Med Assoc 2020; 119:1109-1115. [DOI: 10.1016/j.jfma.2019.07.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 07/11/2019] [Accepted: 07/17/2019] [Indexed: 11/15/2022] Open
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Chiang CP, Wu YH, Wu YC, Chang JYF, Wang YP, Sun A. Anemia, hematinic deficiencies, hyperhomocysteinemia, and serum gastric parietal cell antibody positivity in 884 patients with burning mouth syndrome. J Formos Med Assoc 2020; 119:813-820. [DOI: 10.1016/j.jfma.2019.10.013] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 10/16/2019] [Indexed: 02/06/2023] Open
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16
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Chiang CP, Wu YC, Chang JYF, Wang YP, Wu YH, Sun A. Anemia, hematinic deficiencies, hyperhomocysteinemia, and gastric parietal cell antibody positivity in atrophic glossitis patients with iron deficiency. J Formos Med Assoc 2020; 119:587-594. [DOI: 10.1016/j.jfma.2019.09.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 09/24/2019] [Indexed: 01/27/2023] Open
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17
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Chiang ML, Jin YT, Chiang CP, Wu YH, Yu-Fong Chang J, Sun A. Anemia, hematinic deficiencies, hyperhomocysteinemia, and gastric parietal cell antibody positivity in burning mouth syndrome patients with vitamin B12 deficiency. J Dent Sci 2019; 15:34-41. [PMID: 32256998 PMCID: PMC7109486 DOI: 10.1016/j.jds.2019.12.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Indexed: 12/30/2022] Open
Abstract
Background/purpose Our previous study found that 42 of 884 burning mouth syndrome (BMS) patients have vitamin B12 deficiency. This study assessed whether the vitamin B12-deficient BMS (B12D/BMS) patients had significantly higher frequencies of anemia, hematinic deficiencies, hyperhomocysteinemia, and serum gastric parietal cell antibody (GPCA) positivity than healthy control subjects and evaluated whether all B12D/BMS patients had pernicious anemia (PA). Materials and methods The blood hemoglobin (Hb) and serum iron, vitamin B12, folic acid, homocysteine, and GPCA levels in 42 B12D/BMS patients and 442 healthy control subjects were measured and compared. Results We found that 42 B12D/BMS patients had significantly lower mean blood Hb and serum iron and vitamin B12 levels as well as significantly higher mean corpuscular volume (MCV) and mean serum homocysteine level than healthy control subjects (all P-values < 0.05). Moreover, 42 B12D/BMS patients had significantly higher frequencies of macrocytosis (52.4%), blood Hb (61.9%) and serum iron (26.2%) and vitamin B12 (100.0%) deficiencies, hyperhomocysteinemia (83.3%), and serum GPCA positivity (42.9%) than 442 healthy control subjects (all P-values < 0.001). Moreover, of 26 anemic B12D/BMS patients, 15 (57.7%) had PA, 5 (19.2%) had macrocytic anemia other than PA, 4 (15.4%) had normocytic anemia, and 2 (7.7%) had thalassemia trait-induced anemia. Conclusion B12D/BMS patients have significantly higher frequencies of macrocytosis, blood Hb and serum iron and vitamin B12 deficiencies, hyperhomocysteinemia, and serum GPCA positivity than healthy control subjects. Although PA is the most common type of anemia in our B12D/BMS patients, only 15 (35.7%) of 42 B12D/BMS patients have PA.
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Affiliation(s)
- Meng-Ling Chiang
- Department of Pediatric Dentistry, Chang Gung Memorial Hospital, Taipei, Taiwan.,Department of Oral Pathology and Oral Diagnosis, Chang Gung Memorial Hospital, Taipei, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ying-Tai Jin
- Department of Pathology, Taiwan Adventist Hospital, Taipei, Taiwan.,Department of Pathology, National Cheng-Kung University Hospital, Tainan, Taiwan
| | - Chun-Pin Chiang
- Department of Dentistry, Far Eastern Memorial Hospital, New Taipei City, Taiwan.,Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan.,Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.,Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan
| | - Yu-Hsueh Wu
- Department of Dentistry, Far Eastern Memorial Hospital, New Taipei City, Taiwan.,Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan
| | - Julia Yu-Fong Chang
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan.,Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.,Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan
| | - Andy Sun
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan.,Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
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Anemia, hematinic deficiencies, hyperhomocysteinemia, and gastric parietal cell antibody positivity in burning mouth syndrome patients with iron deficiency. J Dent Sci 2019; 15:42-49. [PMID: 32256999 PMCID: PMC7109489 DOI: 10.1016/j.jds.2019.11.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Indexed: 11/23/2022] Open
Abstract
Background/purpose Our previous study found that 143 of 884 burning mouth syndrome (BMS) patients have iron deficiency (ID). This study assessed whether all BMS patients with ID (so-called ID/BMS patients) had iron deficiency anemia (IDA) and evaluated whether the ID/BMS patients had significantly higher frequencies of anemia, hematinic deficiencies, hyperhomocysteinemia, and serum gastric parietal cell antibody (GPCA) positivity than healthy control subjects. Materials and methods The blood hemoglobin (Hb) and serum iron, vitamin B12, folic acid, homocysteine, and GPCA levels in 143 ID/BMS patients and 442 healthy control subjects were measured and compared. Results We found that 143 ID/BMS patients had significantly lower mean blood Hb and serum iron, vitamin B12, folic acid levels as well as significantly higher mean serum homocysteine level than healthy control subjects (all P-values < 0.01). Moreover, 143 ID/BMS patients had significantly higher frequencies of blood Hb (55.9%) and serum iron (100.0%), vitamin B12 (7.7%), and folic acid (2.1%) deficiencies, hyperhomocysteinemia (27.3%), and serum GPCA positivity (12.6%) than 442 healthy control subjects (all P-values < 0.001). Furthermore, of 80 anemic ID/BMS patients, 5 (6.3%) had pernicious anemia, 5 (6.3%) had macrocytic anemia other than pernicious anemia, 42 (52.5%) had normocytic anemia, 21 (26.3%) had IDA, and 7 (8.8%) had thalassemia trait-induced anemia. Conclusion ID/BMS patients had significantly higher frequencies of blood Hb and serum iron, vitamin B12, and folic acid deficiencies, hyperhomocysteinemia, and serum GPCA positivity than healthy control subjects. Normocytic anemia is the most common type of anemia in ID/BMS patients.
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Hematinic deficiencies, hyperhomocysteinemia, and gastric parietal cell antibody positivity in atrophic glossitis patients with macrocytosis. J Formos Med Assoc 2019; 118:1515-1521. [DOI: 10.1016/j.jfma.2019.07.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 07/03/2019] [Indexed: 01/26/2023] Open
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20
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Wu YC, Wu YH, Chang JYF, Wang YP, Kuo YS, Sun A. Anemia, hematinic deficiencies, hyperhomocysteinemia, and gastric parietal cell antibody positivity in atrophic glossitis patients with vitamin B12 deficiency. J Formos Med Assoc 2019; 119:720-727. [PMID: 31630933 DOI: 10.1016/j.jfma.2019.10.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 10/02/2019] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND/PURPOSE Our previous study found that 56 of 1064 atrophic glossitis (AG) patients have vitamin B12 deficiency. This study assessed whether the AG patients with vitamin B12 deficiency (B12D/AG patients) had significantly higher frequencies of anemia, hematinic deficiencies, hyperhomocysteinemia, and serum gastric parietal cell antibody (GPCA) positivity than healthy control subjects. METHODS The blood hemoglobin (Hb) and serum iron, vitamin B12, folic acid, homocysteine, and GPCA levels in 56 B12D/AG patients and 532 healthy control subjects were measured and compared. RESULTS We found that 56 B12D/AG patients had significantly lower mean blood Hb and serum iron levels as well as significantly higher mean corpuscular volume (MCV) and mean serum homocysteine level than healthy control subjects (all P-values < 0.05). Moreover, 56 B12D/AG patients had significantly higher frequencies of macrocytosis (53.6%), blood Hb (64.3%), iron (26.8%), and folic acid (3.6%) deficiencies, hyperhomocysteinemia (89.3%), and serum GPCA positivity (55.4%) than 532 healthy control subjects (all P-values < 0.005). In addition, of 36 anemic B12D/AG patients, 22 (61.1%) had pernicious anemia (PA), 6 (16.7%) had macrocytic anemia other than PA, 4 (11.1%) had normocytic anemia, 3 (8.3%) had iron deficiency anemia (IDA), and one (2.8%) had microcytic anemia other than IDA and thalassemia trait-induced anemia. CONCLUSION We conclude that B12D/AG patients have significantly higher frequencies of macrocytosis, blood Hb, iron, and folic acid deficiencies, hyperhomocysteinemia, and serum GPCA positivity than healthy control subjects. PA is the most common type of anemia in our B12D/AG patients.
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Affiliation(s)
- Yang-Che Wu
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan; Department of Dentistry, Taipei Medical University-Shuang Ho Hospital, Ministry of Health and Walfare, New Taipei City, Taiwan
| | - Yu-Hsueh Wu
- Department of Dentistry, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan
| | - Julia Yu-Fong Chang
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan; Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan; Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan
| | - Yi-Ping Wang
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan; Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan; Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan
| | - Ying-Shiung Kuo
- Department of Dentistry, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Andy Sun
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan; Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.
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Anemia, hematinic deficiencies, hyperhomocysteinemia, and serum gastric parietal cell antibody positivity in atrophic glossitis patients with or without microcytosis. J Formos Med Assoc 2019; 118:1401-1407. [DOI: 10.1016/j.jfma.2019.06.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 06/10/2019] [Indexed: 12/16/2022] Open
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Wu YH, Wu YC, Chu FY, Cheng SJ, Sun A, Chen HM. Significantly higher frequencies of hematinic deficiencies and hyperhomocysteinemia in oral precancer patients. J Formos Med Assoc 2019; 118:1299-1307. [DOI: 10.1016/j.jfma.2019.05.016] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 04/29/2019] [Accepted: 05/21/2019] [Indexed: 12/13/2022] Open
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23
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Chiang CP, Wu YC, Chang JYF, Wang YP, Wu YH, Sun A. Anemia, hematinic deficiencies, and gastric parietal cell antibody positivity in atrophic glossitis patients with or without hyperhomocysteinemia. J Formos Med Assoc 2019; 119:544-552. [PMID: 31444017 DOI: 10.1016/j.jfma.2019.08.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 08/02/2019] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND/PURPOSE Our previous study found that 127 of 1064 atrophic glossitis (AG) patients have hyperhomocysteinemia. This study assessed whether the AG patients with hyperhomocysteinemia had significantly higher frequencies of anemia, hematinic deficiencies, and serum gastric parietal cell antibody (GPCA) positivity than AG patients without hyperhomocysteinemia or healthy control subjects. METHODS The blood hemoglobin (Hb) and serum iron, vitamin B12, folic acid, homocysteine, and GPCA levels in 127 AG patients with hyperhomocysteinemia, 937 AG patients without hyperhomocysteinemia, and 532 healthy control subjects were measured and compared. RESULTS We found that 127 AG patients with hyperhomocysteinemia had significantly higher frequencies of blood Hb and serum iron, vitamin B12, and folic acid deficiencies and serum GPCA positivity than 532 healthy control subjects (all P-values < 0.001) and significantly higher frequencies of blood Hb and serum vitamin B12 and folic acid deficiencies and serum GPCA positivity than 937 AG patients without hyperhomocysteinemia (all P-values < 0.001). Moreover, 127 AG patients with hyperhomocysteinemia had significantly higher frequencies of macrocytic anemia and significantly lower frequencies of normocytic anemia than 937 AG patients without hyperhomocysteinemia (both P-values < 0.001). Pernicious anemia (22 cases) was found only in AG patients with hyperhomocysteinemia but not in AG patients without hyperhomocysteinemia. CONCLUSION AG patients with hyperhomocysteinemia had significantly higher frequencies of anemia, serum iron, vitamin B12, and folic acid deficiencies, and serum GPCA positivity than healthy control subjects and significantly higher frequencies of anemia, serum vitamin B12 and folic acid deficiencies, and serum GPCA positivity than AG patients without hyperhomocysteinemia.
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Affiliation(s)
- Chun-Pin Chiang
- Department of Dentistry, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan; Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan; Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan
| | - Yang-Che Wu
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - Julia Yu-Fong Chang
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan; Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan; Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan
| | - Yi-Ping Wang
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan; Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan; Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan
| | - Yu-Hsueh Wu
- Department of Dentistry, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan
| | - Andy Sun
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan; Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.
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Kuo YS, Wu YH, Chang JYF, Wang YP, Wu YC, Sun A. Blood profile of atrophic glossitis patients with thyroglobulin antibody/thyroid microsomal antibody positivity but without gastric parietal cell antibody positivity. J Formos Med Assoc 2019; 118:1218-1224. [DOI: 10.1016/j.jfma.2019.04.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 04/02/2019] [Indexed: 11/28/2022] Open
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Does serum gastric parietal cell antibody titer have influence on anemia and vitamin B12 deficiency in atrophic glossitis patients? J Formos Med Assoc 2019; 119:377-383. [PMID: 31277918 DOI: 10.1016/j.jfma.2019.06.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 06/17/2019] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND/PURPOSE Our previous study found 284 gastric parietal cell antibody (GPCA)-positive atrophic glossitis (AG) patients (so-called GPCA+AG patients in this study) in a group of 1064 AG patients. This study evaluated whether high-titer (GPCA titer ≥ 160) GPCA+AG patients had greater frequencies of anemia, vitamin B12 deficiency, macrocytosis, and hyperhomocysteinemia than low-titer (GPCA titer < 160) GPCA+AG patients. METHODS Complete blood count, serum iron, vitamin B12, folic acid, homocysteine, and GPCA levels in 117 high-titer GPCA+AG patients, 167 low-titer GPCA+AG patients, and 532 healthy control subjects were measured and compared. RESULTS We found that 12.0%, 29.1%, 23.1%, 16.2%, 1.7%, and 23.1% of 117 high-titer GPCA+AG patients and 5.4%, 17.4%, 17.4%, 7.2%, 1.2%, and 14.4% of 167 low-titer GPCA+AG patients were diagnosed as having macrocytosis, blood hemoglobin, iron, vitamin B12, and folic acid deficiencies, and hyperhomocysteinemia, respectively. Moreover, both 117 high-titer and 167 low-titer GPCA+AG patients had significantly greater frequencies of macrocytosis, blood hemoglobin, serum iron and vitamin B12 deficiencies, and hyperhomocysteinemia than 532 healthy control subjects (all P-values < 0.05). In addition, 117 high-titer GPCA+AG patients also had greater frequencies of anemia (P = 0.029, statistically significant), serum vitamin B12 deficiency (P = 0.027, statistically significant), macrocytosis (P = 0.075, marginal significance), and hyperhomocysteinemia (P = 0.085, marginal significance) than 167 low-titer GPCA+AG patients. CONCLUSION For GPCA+AG patients, high-titer GPCA+AG patients have greater frequencies of anemia, serum vitamin B12 deficiency, macrocytosis, and hyperhomocysteinemia than low-titer GPCA+AG patients.
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Hematinic deficiencies and hyperhomocysteinemia in gastric parietal cell antibody-positive or gastric and thyroid autoantibodies-negative atrophic glossitis patients. J Formos Med Assoc 2019; 118:1114-1121. [DOI: 10.1016/j.jfma.2019.03.017] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Accepted: 03/26/2019] [Indexed: 01/25/2023] Open
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Wu YH, Wu YC, Cheng SJ, Kuo YS, Sun A, Chen HM. Gastric parietal cell and thyroid autoantibodies in oral precancer patients. J Formos Med Assoc 2019; 118:1393-1400. [PMID: 31200999 DOI: 10.1016/j.jfma.2019.05.017] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 05/21/2019] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND/PURPOSE Gastric parietal cell antibody (GPCA), thyroglobulin antibody (TGA), and thyroid microsomal antibody (TMA) may be present in oral mucosal disease patients. This study mainly assessed the frequencies of serum GPCA, TGA, and TMA positivities in 131 oral precancer patients. METHODS Serum GPCA, TGA, and TMA levels were measured in 131 oral precancer patients including 96 oral leukoplakia, 26 oral erythroleukoplakia, and 9 oral verrucous hyperplasia patients and in 131 age- and sex-matched healthy control subjects. RESULTS We found that 131 oral precancer patients had higher frequencies of serum GPCA (10.7% vs. 2.3%, P = 0.012, statistically significant), TGA (4.6% vs. 2.3%, P = 0.498), and TMA (8.4% vs. 2.3%, P = 0.054, marginal significance) positivities than 131 healthy control subjects. We also found that 1 (0.8%), 6 (4.6%), and 16 (12.2%) oral precancer patients had the presence of three (GPCA + TGA + TMA), two (GPCA + TGA, GPCA + TMA, or TGA + TMA), or one (GPCA only, TGA only, or TMA only) autoantibody in their sera, respectively. Of 10 TGA/TMA-positive oral precancer patients whose serum thyroid-stimulating hormone (TSH) levels were measured, 80%, 10%, and 10% of these 10 TGA/TMA-positive oral precancer patients had normal, lower, and higher serum TSH levels, respectively. We also found a significantly higher GPCA positive rate in 26 smokers consuming >20 cigarettes per day than in 61 smokers consuming ≤20 cigarettes per day (P = 0.008). CONCLUSION Approximately 17.6% of 131 oral precancer patients have serum GPCA/TGA/TMA positivity. Only approximately 20% of TGA/TMA-positive oral precancer patients have either hypothyroidism or hyperthyroidism.
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Affiliation(s)
- Yu-Hsueh Wu
- Department of Dentistry, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan
| | - Yang-Che Wu
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - Shih-Jung Cheng
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan; Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan; Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan
| | - Ying-Shiung Kuo
- Department of Dentistry, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Andy Sun
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan; Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Hsin-Ming Chen
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan; Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan; Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan.
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Chiang CP, Yu-Fong Chang J, Wang YP, Wu YH, Wu YC, Sun A. Gastric parietal cell and thyroid autoantibodies in patients with atrophic glossitis. J Formos Med Assoc 2019; 118:973-978. [DOI: 10.1016/j.jfma.2019.01.016] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 01/21/2019] [Indexed: 12/22/2022] Open
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Atrophic glossitis: Etiology, serum autoantibodies, anemia, hematinic deficiencies, hyperhomocysteinemia, and management. J Formos Med Assoc 2019; 119:774-780. [PMID: 31076315 DOI: 10.1016/j.jfma.2019.04.015] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 04/23/2019] [Indexed: 12/19/2022] Open
Abstract
Atrophic glossitis (AG) is characterized by the partial or complete absence of filiform papillae on the dorsal surface of the tongue. AG may reflect the significant deficiencies of some major nutrients including riboflavin, niacin, pyridoxine, vitamin B12, folic acid, iron, zinc, and vitamin E. Moreover, protein-calorie malnutrition, candidiasis, Helicobacter pylori colonization, xerostomia, and diabetes mellitus are also the etiologies of AG. Our previous study found the serum gastric parietal cell antibody (GPCA), thyroglobulin antibody (TGA), and thyroid microsomal antibody (TMA) positivities in 26.7%, 28.4%, and 29.8% of 1064 AG patients, respectively. We also found anemia, serum iron, vitamin B12, and folic acid deficiencies, and hyperhomocysteinemia in 19.0%, 16.9%, 5.3%, 2.3%, and 11.9% of 1064 AG patients, respectively. Moreover, GPCA-positive AG patients tended to have relatively higher frequencies of hemoglobin, iron, and vitamin B12 deficiencies and hyperhomocysteinemia than GPCA-negative AG patients. Supplementations with vitamin BC capsules plus corresponding deficient hematinics for those AG patients with hematinic deficiencies can achieve complete remission of oral symptoms and AG in some AG patients. Therefore, it is very important to examine the complete blood count, serum hematinic, homocysteine, and autoantibody levels in AG patients before we start to offer treatments for AG patients.
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Chiang CP, Chang JYF, Wang YP, Wu YH, Wu YC, Sun A. Anemia, hematinic deficiencies, and hyperhomocysteinemia in gastric parietal cell antibody-positive and -negative atrophic glossitis patients. J Formos Med Assoc 2019; 118:565-571. [DOI: 10.1016/j.jfma.2018.12.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Accepted: 12/05/2018] [Indexed: 01/09/2023] Open
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Ernawati D, Surboyo MC, Parmadiati A. Glossitis mimicking median rhomboid glossitis induced by throat lozenges and refreshment candies. J Int Oral Health 2019. [DOI: 10.4103/jioh.jioh_76_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Chiang CP, Wu YH, Chang JYF, Wang YP, Wu YC, Sun A. Hematinic deficiencies and hyperhomocysteinemia in gastric parietal cell antibody-positive or gastric and thyroid autoantibodies-negative Behcet's disease patients. J Formos Med Assoc 2019; 118:347-353. [DOI: 10.1016/j.jfma.2018.05.017] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 05/16/2018] [Accepted: 05/24/2018] [Indexed: 12/31/2022] Open
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Chiang CP, Chang JYF, Wang YP, Wu YC, Wu YH, Sun A. Significantly higher frequencies of anemia, hematinic deficiencies, hyperhomocysteinemia, and serum gastric parietal cell antibody positivity in atrophic glossitis patients. J Formos Med Assoc 2018; 117:1065-1071. [DOI: 10.1016/j.jfma.2018.07.016] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 07/19/2018] [Indexed: 12/24/2022] Open
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Kuo YS, Chang JYF, Wang YP, Wu YC, Wu YH, Sun A. Significantly higher frequencies of hemoglobin, iron, vitamin B12, and folic acid deficiencies and of hyperhomocysteinemia in patients with Behcet's disease. J Formos Med Assoc 2018; 117:932-938. [DOI: 10.1016/j.jfma.2018.04.007] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 04/11/2018] [Accepted: 04/13/2018] [Indexed: 01/16/2023] Open
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Chiang CP, Wu YH, Yu-Fong Chang J, Wang YP, Chen HM, Sun A. Serum thyroid autoantibodies are not associated with anemia, hematinic deficiencies, and hyperhomocysteinemia in patients with Behcet's disease. J Dent Sci 2018; 13:256-262. [PMID: 30895129 PMCID: PMC6388837 DOI: 10.1016/j.jds.2018.05.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2018] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND/PURPOSE Our previous study found that 13 of 63 recurrent aphthous stomatitis (RAS)/Behcet's disease (BD) patients have thyroglobulin antibody (TGA) positivity and/or thyroid microsomal antibody (TMA) positivity (TGA/TMA positivity) but without gastric parietal cell antibody positivity. This study mainly assessed whether the serum TGA/TMA positivity was significantly associated with anemia, hematinic deficiencies, and hyperhomocysteinemia in TGA/TMA-positive RAS/BD patients. MATERIALS AND METHODS The mean blood hemoglobin (Hb), iron, vitamin B12, folic acid, and homocysteine levels were measured and compared between 13 TGA/TMA-positive RAS/BD patients and 41 gastric and thyroid antibodies-negative RAS/BD patients (Abs־RAS/BD patients) or 126 healthy control subjects. RESULTS We found no significant differences in the mean blood Hb, iron, vitamin B12, folic acid, and homocysteine leve1s as well as no significant differences in the frequencies of blood Hb and folic acid deficiencies and of hyperhomocysteinemia between 13 TGA/TMA-positive RAS/BD patients and 41 Abs־RAS/BD patients. The 41 Abs־RAS/BD patients even had a significantly greater frequency of serum iron deficiency than the 13 TGA/TMA-positive RAS/BD patients. Moreover, although a significant greater frequency of anemia was demonstrated in 13 TGA/TMA-positive RAS/BD patients than in 126 healthy control subjects, there were no significant differences in the mean serum iron, vitamin B12, folic acid, and homocysteine levels as well as no significant differences in the frequencies of serum iron and folic acid deficiencies and of hyperhomocysteinemia between 13 TGA/TMA-positive RAS/BD patients and 126 healthy control subjects. CONCLUSION The serum TGA/TMA-positivity is not significantly associated with anemia, hematinic deficiencies, and hyperhomocysteinemia in TGA/TMA-positive RAS/BD patients.
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Affiliation(s)
- Chun-Pin Chiang
- Department of Dentistry, Far Eastern Memorial Hospital, New Taipei City, Taiwan
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan
- Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
- Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan
| | - Yu-Hsueh Wu
- Department of Dentistry, Far Eastern Memorial Hospital, New Taipei City, Taiwan
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan
| | - Julia Yu-Fong Chang
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan
- Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
- Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan
| | - Yi-Ping Wang
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan
- Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
- Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan
| | - Hsin-Ming Chen
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan
- Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
- Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan
| | - Andy Sun
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan
- Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
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Wu YH, Chang JYF, Wang YP, Wu YC, Chen HM, Sun A. Gastric parietal cell and thyroid autoantibodies in Behcet's disease patients with or without atrophic glossitis. J Formos Med Assoc 2018; 117:691-696. [DOI: 10.1016/j.jfma.2018.03.015] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 03/26/2018] [Accepted: 03/27/2018] [Indexed: 01/10/2023] Open
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37
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Wu YH, Yu-Fong Chang J, Wang YP, Wu YC, Chen HM, Sun A. Hemoglobin, iron, vitamin B12, and folic acid deficiencies and hyperhomocysteinemia in Behcet's disease patients with atrophic glossitis. J Formos Med Assoc 2018; 117:559-565. [DOI: 10.1016/j.jfma.2018.03.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 03/06/2018] [Accepted: 03/08/2018] [Indexed: 01/17/2023] Open
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Lin HP, Wu YH, Yu-Fong Chang J, Wang YP, Chen HM, Sun A. Gastric parietal cell and thyroid autoantibodies in patients with Behcet's disease. J Formos Med Assoc 2018; 117:505-511. [DOI: 10.1016/j.jfma.2018.03.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 02/21/2018] [Accepted: 03/01/2018] [Indexed: 01/19/2023] Open
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Chiang CP, Yu-Fong Chang J, Wu YH, Sun A, Wang YP, Chen HM. Hematinic deficiencies and anemia in gastric parietal cell antibody-positive and -negative oral submucous fibrosis patients. J Dent Sci 2018; 13:68-74. [PMID: 30895097 PMCID: PMC6388861 DOI: 10.1016/j.jds.2018.02.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND/PURPOSE Previous studies showed that approximately 13-15% of male oral submucous fibrosis (OSF) patients are serum gastric parietal cell antibody (GPCA)-positive. This study assessed whether serum GPCA or OSF itself was a significant factor that caused hematinic deficiencies and anemia statuses in GPCA-positive or GPCA-negative OSF patients (GPCA+/OSF and GPCA-/OSF patients). MATERIALS AND METHODS The frequencies of macrocytosis (mean corpuscular volume or MCV ≧ 100 fL) and blood hemoglobin (Hb), iron, vitamin B12 and folic acid deficiencies were determined and compared between any two of the four groups of 149 male OSF, 23 male GPCA+/OSF, and 126 male GPCA-/OSF patients and 149 age-matched male healthy control subjects. RESULTS All three groups of OSF patients (including 149 OSF, 23 GPCA+/OSF, and 126 GPCA-/OSF patients) had a significantly higher frequency of Hb, vitamin B12, or folic acid deficiency and of macrocytosis than 149 healthy control subjects (all P-values < 0.05). The 23 GPCA+/OSF patients did have a significantly lower mean serum vitamin B12 level and a significantly higher MCV or frequency of vitamin B12 deficiency than the 126 GPCA-/OSF patients. Two of the 23 GPCA+/OSF patients had pernicious anemia. Of the 126 GPCA-/OSF patients, 6 had macrocytic anemia, 2 had iron deficiency anemia, and 4 had thalassemia trait-induced anemia. CONCLUSION We conclude that OSF itself does play a significant role in causing hematinic deficiencies and anemia in OSF, GPCA+/OSF, and GPCA-/OSF patients. The serum GPCA is the major factor that causes vitamin B12 deficiency, macrocytosis, and pernicious anemia in GPCA+/OSF patients.
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Affiliation(s)
- Chun-Pin Chiang
- Department of Dentistry, Far Eastern Memorial Hospital, Taipei, Taiwan
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan
- Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
- Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan
| | - Julia Yu-Fong Chang
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan
- Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
- Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan
| | - Yu-Hsueh Wu
- Department of Dentistry, Far Eastern Memorial Hospital, Taipei, Taiwan
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan
| | - Andy Sun
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan
- Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yi-Ping Wang
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan
- Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
- Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan
| | - Hsin-Ming Chen
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan
- Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
- Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan
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Hematinic deficiencies and anemia statuses in anti-gastric parietal cell antibody-positive or all autoantibodies-negative erosive oral lichen planus patients. J Formos Med Assoc 2018; 117:227-234. [DOI: 10.1016/j.jfma.2017.12.009] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 12/05/2017] [Accepted: 12/13/2017] [Indexed: 12/24/2022] Open
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Chiang CP, Yu-Fong Chang J, Wang YP, Wu YH, Lu SY, Sun A. Oral lichen planus - Differential diagnoses, serum autoantibodies, hematinic deficiencies, and management. J Formos Med Assoc 2018; 117:756-765. [PMID: 29472048 DOI: 10.1016/j.jfma.2018.01.021] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 01/26/2018] [Accepted: 01/30/2018] [Indexed: 01/06/2023] Open
Abstract
Oral lichen planus (OLP) is a chronic inflammatory oral mucosal disease that occurs more frequently in middle-aged and elderly female patients. Previous studies indicate that OLP is a T-cell dysfunction-induced localized autoimmune disease. Clinically, six types of OLP, namely reticular, papular, plaque-like, atrophic/erosive, ulcerative, and bullous types, can be identified. OLP more commonly affects buccal mucosa, tongue, and gingiva. It always has a bilateral and symmetric distribution of the oral lesions. Plaque-like and atrophic/erosive OLP may be misdiagnosed as oral leukoplakia and oral erythroleukoplakia, respectively. Our previous study found serum autoantibodies in 195 (60.9%) of the 320 OLP patients. Specific serum anti-nuclear, anti-smooth muscle, anti-mitochondrial, gastric parietal cell, thyroglobulin, and thyroid microsomal autoantibodies are present in 28.1%, 8.4%, 1.6%, 26.3%, 21.3%, and 24.4% of 320 OLP patients, respectively. Furthermore, we also discovered that 21.9%, 13.6%, 7.1%, 0.3%, and 14.8% of 352 OLP patients have hemoglobin, iron, vitamin B12, and folic acid deficiencies, and abnormally high serum homocysteine level, respectively. Therefore, it is very important to examine the serum autoantibody, hematinic and homocysteine levels in OLP patients before starting the treatments for OLP patients. Because OLP is an immunologically-mediated disease, corticosteroids are the drugs of choice for treatment of OLP.
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Affiliation(s)
- Chun-Pin Chiang
- Department of Dentistry, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan; Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan; Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan
| | - Julia Yu-Fong Chang
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan; Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan; Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan
| | - Yi-Ping Wang
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan; Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan; Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan
| | - Yu-Hsueh Wu
- Department of Dentistry, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan
| | - Shin-Yu Lu
- Oral Pathology and Family Dentistry Section, Department of Dentistry, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Andy Sun
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan; Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.
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Anemia and hematinic deficiencies in gastric parietal cell antibody-positive and -negative oral mucosal disease patients with microcytosis. J Formos Med Assoc 2017; 116:613-619. [DOI: 10.1016/j.jfma.2017.02.001] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Accepted: 02/03/2017] [Indexed: 01/19/2023] Open
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43
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Anemia and hematinic deficiencies in oral mucosal disease patients with microcytosis. J Formos Med Assoc 2017; 116:505-511. [DOI: 10.1016/j.jfma.2017.02.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 02/03/2017] [Accepted: 02/07/2017] [Indexed: 11/21/2022] Open
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Anemia and hematinic deficiencies in anti-gastric parietal cell antibody-positive and -negative recurrent aphthous stomatitis patients with anti-thyroid antibody positivity. J Formos Med Assoc 2017; 116:145-152. [DOI: 10.1016/j.jfma.2016.10.008] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 10/12/2016] [Accepted: 10/14/2016] [Indexed: 12/21/2022] Open
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Lin HP, Wu YH, Wang YP, Wu YC, Chang JYF, Sun A. Anemia and hematinic deficiencies in anti-gastric parietal cell antibody-positive or all autoantibodies-negative recurrent aphthous stomatitis patients. J Formos Med Assoc 2017; 116:99-106. [DOI: 10.1016/j.jfma.2016.10.006] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 10/09/2016] [Indexed: 01/17/2023] Open
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Hematinic deficiencies and anemia statuses in recurrent aphthous stomatitis patients with or without atrophic glossitis. J Formos Med Assoc 2016; 115:1061-1068. [DOI: 10.1016/j.jfma.2016.10.007] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Revised: 10/08/2016] [Accepted: 10/14/2016] [Indexed: 01/18/2023] Open
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Erriu M, Pili FMG, Cadoni S, Garau V. Diagnosis of Lingual Atrophic Conditions: Associations with Local and Systemic Factors. A Descriptive Review. Open Dent J 2016; 10:619-635. [PMID: 27990187 PMCID: PMC5123136 DOI: 10.2174/1874210601610010619] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2016] [Revised: 10/09/2016] [Accepted: 10/15/2016] [Indexed: 12/16/2022] Open
Abstract
Atrophic glossitis is a condition characterised by absence of filiform or fungiform papillae on the dorsal surface of the tongue. Consequently, the ordinary texture and appearance of the dorsal tongue, determined by papillary protrusion, turns into a soft and smooth aspect. Throughout the years, many factors, both local and systemic, have been associated with atrophic glossitis as the tongue is currently considered to be a mirror of general health. Moreover, various tongue conditions were wrongly diagnosed as atrophic glossitis. Oral involvement can conceal underlying systemic conditions and, in this perspective, the role of clinicians is fundamental. Early recognition of oral signs and symptoms, through a careful examination of oral anatomical structures, plays a crucial role in providing patients with a better prognosis.
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Affiliation(s)
- M Erriu
- Department of Surgical Sciences, Cagliari University, Cagliari, Italy
| | - F M G Pili
- Department of Surgical Sciences, Cagliari University, Cagliari, Italy
| | - S Cadoni
- Digestive Endoscopy Unit, S. Barbara Hospital, Iglesias (CA), Italy
| | - V Garau
- Department of Surgical Sciences, Cagliari University, Cagliari, Italy
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Anemia and hematinic deficiencies in gastric parietal cell antibody-positive and antibody-negative erosive oral lichen planus patients with thyroid antibody positivity. J Formos Med Assoc 2016; 115:1004-1011. [DOI: 10.1016/j.jfma.2016.09.007] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Accepted: 09/22/2016] [Indexed: 01/23/2023] Open
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49
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Sun A, Chang JYF, Wang YP, Cheng SJ, Chen HM, Chiang CP. Effective vitamin B12 treatment can reduce serum antigastric parietal cell antibody titer in patients with oral mucosal disease. J Formos Med Assoc 2016; 115:837-844. [DOI: 10.1016/j.jfma.2016.05.003] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Revised: 05/14/2016] [Accepted: 05/24/2016] [Indexed: 11/17/2022] Open
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50
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Hematinic deficiencies and anemia statuses in antigastric parietal cell antibody-positive erosive oral lichen planus patients with desquamative gingivitis. J Formos Med Assoc 2016; 115:860-866. [DOI: 10.1016/j.jfma.2016.07.006] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 07/05/2016] [Indexed: 01/02/2023] Open
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