vitamin-b-12 and Mouth-Diseases

Patients with microcytosis (defined as mean corpuscular volume < 80 fL) are not uncommonly found in oral mucosal disease clinics. This study assessed the anemia statuses and hematinic deficiencies in 240 oral mucosal disease patients with microcytosis.. The mean red blood cell (RBC) count, mean corpuscular volume, and RBC distribution width, as well as blood concentrations of hemoglobin (Hb), iron, vitamin B12, folic acid, and homocysteine in 240 microcytosis patients and in 240 age- and sex-matched healthy control individuals were measured and compared.. We conclude that approximately 45%, 4%, and 5% of microcytosis patients have iron, vitamin B12, and folic acid deficiencies, respectively, and approximately 10% of microcytosis patients have abnormally high homocysteine levels. Moreover, 67.5% of 240 microcytosis patients and 50.8% of 120 TT patients had anemia. Iron deficiency anemia is the most common type of anemia in microcytosis patients, followed by TT-induced anemia and other microcytic anemia.

Topics: Anemia; Erythrocyte Count; Erythrocyte Indices; Humans; Mouth Diseases; Vitamin B 12

Topics: Adrenal Cortex Hormones; Age Factors; Antidepressive Agents; Drug Therapy, Combination; Female; Humans; Middle Aged; Mouth Diseases; Pain; Postmenopause; Prognosis; Risk Assessment; Risk Factors; Vitamin B 12

Topics: Adolescent; Adult; Aged; Animals; Biotin; Chemical Phenomena; Chemistry; Child; Female; Folic Acid; Folic Acid Deficiency; Humans; Infant; Infant, Newborn; Male; Mouth Diseases; Nicotinic Acids; Nutritional Requirements; Pellagra; Pregnancy; Riboflavin; Riboflavin Deficiency; Thiamine; Thiamine Deficiency; Tryptophan; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin B Complex; Vitamin B Deficiency

Oral manifestations of deficiency of iron, vitamin B12 and folic acid are thought to be common. Prevalence of these deficiencies among patients with compatible symptoms is not well known. The goal of this study was to summarize evidence from a dental practice of iron, vitamin B12 and folic acid deficiency in patients presenting with compatible oral manifestations.. 250 patients who presented with burning mouth syndrome, angular cheilitis, recurrent aphthous stomatitis, papillar atrophy of the tongue dorsum or mucosal erythema were identified. Patients underwent clinical examination, and the blood samples were taken.. 250 patients (208 females; 42 males, mean age 44.1 years) with at least one corresponding symptom or sign were identified. The nutritional deficiency of one or more nutrients was found in 119 patients (47.6%). Seven times more females than males were noted to have one type of deficiency (104 females, 15 males). Iron deficiency as defined was diagnosed in 62 patients (24.8%), vitamin B12 or folic acid deficiency in 44 patients (17.6%) and both deficiencies (iron + vitamin B12/folic acid) in 13 patients (5.2%). The only predictive factor was gender and only for iron deficiency. The presence of more than one deficiency was noted in 10 patients (4.9%).. The most commonly observed deficiency in dental practice over the course of 11 years was an iron deficiency in the female population. Age, diet and reported co-morbidities did not show statistically significant predictable value in recognizing these deficiencies.

Topics: Adult; Czech Republic; Female; Folic Acid; Folic Acid Deficiency; Humans; Iron; Iron Deficiencies; Male; Malnutrition; Mouth Diseases; Practice Patterns, Dentists'; Sex Factors; Vitamin B 12; Vitamin B 12 Deficiency

Our previous studies found relatively higher frequencies of anemia, hematinic deficiencies, and hyperhomocysteinemia in patients with different types of oral mucosal diseases. This study evaluated whether patients with oral precancerous lesions (oral precancer patients) had significantly higher frequencies of anemia, hematinic deficiencies, and hyperhomocysteinemia than healthy control subjects.. The complete blood count, serum iron, vitamin B12, folic acid, and homocysteine levels 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 were measured and compared.. We found significantly lower mean serum iron (for women only), vitamin B12, and folic acid levels and a significantly higher mean serum homocysteine level in oral precancer patients than in healthy control subjects (all P-values < 0.05). Moreover, 131 oral precancer patients had significantly higher frequencies of blood hemoglobin (3.1%), vitamin B12 (43.5%), and folic acid (46.6%) deficiencies and hyperhomocysteinemia (22.1%) than 131 healthy control subjects (all P-values < 0.05). Of 131 oral precancer patients, lower mean serum folic acid levels were found in 87 cigarette smokers than in 44 non-smokers (P = 0.002), in 26 smokers consuming > 20 cigarettes per day than in 61 smokers consuming ≤ 20 cigarettes per day (P = 0.024), and in 52 betel quid chewers than in 79 non-chewers (P = 0.051).. There are significantly higher frequencies of anemia, serum vitamin B12, and folic acid deficiencies, and hyperhomocysteinemia in oral precancer patients than in healthy control subjects.

Topics: Adult; Aged; Anemia; Autoantibodies; Case-Control Studies; Erythrocyte Indices; Female; Folic Acid; Folic Acid Deficiency; Hematinics; Hemoglobins; Humans; Hyperhomocysteinemia; Iron; Leukoplakia, Oral; Male; Middle Aged; Mouth Diseases; Parietal Cells, Gastric; Sex Factors; Taiwan; Vitamin B 12; Vitamin B 12 Deficiency

Microcytosis is defined as mean corpuscular volume (MCV) < 80 fL. This study assessed the anemia statuses and hematinic deficiencies in 30 patients with gastric parietal cell antibody-positive microcytosis (GPCA+/microcytosis) and 210 patients with GPCA-negative microcytosis (GPCA-/microcytosis).. We measured and compared the mean red blood cell (RBC) count, MCV, and RBC distribution width (RDW), as well as blood levels of hemoglobin, iron, vitamin B12, folic acid, and homocysteine among the aforementioned patient groups and 240 healthy controls.. We conclude that GPCA in microcytosis patients' sera may have caused significantly lower mean vitamin B12 level as well as significantly higher mean RDW and serum homocysteine level in our GPCA+/microcytosis patients than in GPCA-/microcytosis patients. Herein, iron deficiency anemia was the most common type of anemia in anemic GPCA+/microcytosis and GPCA-/microcytosis patients.

Topics: Adult; Aged; Aged, 80 and over; Anemia; Autoantibodies; Erythrocyte Count; Erythrocyte Indices; Female; Homocysteine; Humans; Male; Middle Aged; Mouth Diseases; Mouth Mucosa; Parietal Cells, Gastric; Vitamin B 12

Topics: Autoantibodies; Blood Chemical Analysis; Folic Acid; Hemoglobins; Humans; Iron; Mouth Diseases; Mouth Mucosa; Parietal Cells, Gastric; Vitamin B 12

The purpose of this study was to compare clinical features of vitamin B12 deficiency patients with a history of gastrectomy to those without a history of gastrectomy.. Twenty-two patients with vitamin B12 deficiency were included. Patients' chief complaints, oral manifestations, blood examination results, and past medical histories were reviewed.. Eleven patients had a history of gastrectomy and 11 did not. The chief complaint was glossodynia in all patients. No significant differences were observed between the two groups regarding age, sex, symptom duration, or plasma vitamin B12 level. Erythema and depapillation of the tongue were the most common findings, however less common among patients without a history of gastrectomy. Two patients with a history of gastrectomy and 5 patients without a history of gastrectomy had normal oral mucosa. Patients with a history of gastrectomy were more anemic. Oral symptoms of the majority of patients responded to antifungals and vitamin B12 replacement. The suggested etiologies for vitamin B12 deficiency in the patients without a history of gastrectomy were gastritis, medications, diet, autoimmunity, and early gastric cancer.. Vitamin B12 deficiency and its associated etiological factors should be considered in patients with glossodynia, even those whose oral mucosa appears normal and who lack a history of gastrectomy.

Topics: Diet; Gastrectomy; Humans; Mouth Diseases; Vitamin B 12; Vitamin B 12 Deficiency

Vitamin B12 and iron deficiencies lead to macrocytosis [mean corpuscular volume (MCV) ≥ 100 fL] and microcytosis (MCV < 80 fL), respectively. This study evaluated anemic status, MCV, serum homocysteine level, and serum gastric parietal cell antibody (GPCA) level in oral mucosal disease patients with both vitamin B12 and iron deficiencies.. The blood hemoglobin (Hb), iron, vitamin B12, folic acid and homocysteine concentrations, MCV, and serum GPCA in 149 patients with both vitamin B12 and iron deficiencies were measured and compared with the corresponding data in 149 age- and sex-matched healthy control subjects.. We found that 54 (36.2%), 16 (10.7%), 44 (29.5%), and 36 (24.2%) patients with both vitamin B12 and iron deficiencies had Hb deficiency (men <13 g/dL, women <12 g/dL), folic acid deficiency (≤ 6 mg/mL), abnormally high blood homocysteine level (>12.6 μM), and serum GPCA positivity, respectively. Patients with both vitamin B12 and iron deficiencies had a significantly higher frequency of Hb deficiency, abnormally elevated blood homocysteine level, and serum GPCA positivity than healthy control subjects (all p values < 0.001). Of 149 patients with both vitamin B12 and iron deficiencies, 10 (6.7%) had high MCV (≥ 100 fL), 108 (72.5%) had normal MCV (between 80 fL and 99 fL), and 31 (20.8%) had low MCV (<80 fL).. Approximately 73%, 30%, and 24% of patients with both vitamin B12 and iron deficiencies are found to have normal MCV, abnormally high blood homocysteine level, and serum GPCA positivity, respectively.

Topics: Adult; Aged; Autoantibodies; Case-Control Studies; Erythrocyte Indices; Female; Folic Acid; Folic Acid Deficiency; Hemoglobins; Homocysteine; Humans; Iron; Iron Deficiencies; Male; Middle Aged; Mouth Diseases; Parietal Cells, Gastric; Taiwan; Vitamin B 12; Vitamin B 12 Deficiency

Macrocytosis is defined as having the mean corpuscular volume (MCV) ≥ 100 fL. This study assessed hematinic deficiencies and pernicious anemia (PA) in oral mucosal disease patients with macrocytosis.. The blood hemoglobin (Hb), iron, vitamin B12, folic acid, and homocysteine concentrations and MCV in 60 oral mucosal disease patients with macrocytosis were measured and compared with the corresponding data in 120 age- and sex-matched healthy control participants. PA was defined by the World Health Organization (WHO) as having an Hb concentration < 13 g/dL for men and < 12 g/dL for women, an MCV ≥ 100 fL, a serum vitamin B12 level < 200 pg/mL, and serum gastric parietal cell antibody (GPCA) positivity.. We found that 30 (50.0%), 7 (11.7%), 24 (40.0%), and three (5.0%) oral mucosal disease patients with macrocytosis had deficiencies of Hb (men < 13 g/dL, women < 12 g/dL), iron (< 60 μg/dL), vitamin B12 (< 200 pg/mL), and folic acid (< 4 mg/mL), respectively. Moreover, 38 (63.3%) and 16 (26.7%) macrocytosis patients had abnormally high blood homocysteine level (> 12.3 μM) and serum GPCA positivity, respectively. Macrocytosis patients had a significantly higher frequency of Hb, iron, or vitamin B12 deficiency, of abnormally elevated blood homocysteine level, and of GPCA positivity than healthy control participants (p < 0.001). However, only 16.7% of 60 macrocytosis patients were diagnosed as having PA by the WHO definition.. Only 16.7% of oral mucosal disease patients with macrocytosis are discovered to have PA by the WHO definition.

Topics: Adult; Aged; Aged, 80 and over; Anemia, Iron-Deficiency; Anemia, Pernicious; Autoantibodies; Case-Control Studies; Erythrocyte Indices; Erythrocytes, Abnormal; Female; Folic Acid; Folic Acid Deficiency; Hematologic Diseases; Hemoglobins; Humans; Iron; Male; Middle Aged; Mouth Diseases; Parietal Cells, Gastric; Taiwan; Vitamin B 12; Young Adult

Folic acid deficiency (FAD) may result in macrocytic anemia. This study assessed the hematinic deficiencies and anemia statuses in oral mucosal disease patients with FAD (defined as folic acid ≤ 6 ng/mL).. The blood hemoglobin (Hb), iron, vitamin B12, and folic acid concentrations, serum gastric parietal cell antibody level, and mean corpuscular volume (MCV) in 198 oral mucosal disease patients with FAD were measured. Based on World Health Organization (WHO) criteria, anemia or Hb deficiency was defined as having an Hb concentration of <13 g/dL for men and <12 g/dL for women. In this study, macrocytic anemia due to FAD was defined as having an MCV ≥100 fL and folic acid ≤6 ng/mL; pernicious anemia as having MCV ≥100 fL, vitamin B12 < 200 pg/mL, and serum gastric parietal cell antibody positivity; iron deficiency anemia as having MCV <80 fL and iron <60 μg/dL; and thalassemia trait as having MCV <74 fL, red blood cell (RBC) count > 5.0 × 10(12)/L, and Mentzer index (MCV/RBC) < 13.. We found that by WHO definitions, 73 (36.9%), 41 (20.7%), and 10 (5.1%) of our 198 FAD patients had concomitant Hb, iron, and vitamin B12 deficiencies, respectively. Of 73 anemic FAD patients, three had macrocytic anemia due to FAD, one had pernicious anemia, 14 had iron deficiency anemia, eight had thalassemia trait, and the resting 47 had normocytic anemia.. In addition to macrocytic anemia (2.0%), FAD patients may have concomitant normocytic (23.7%) or microcytic (11.1%) anemia.

Topics: Adult; Aged; Aged, 80 and over; Anemia, Iron-Deficiency; Anemia, Macrocytic; Autoantibodies; Case-Control Studies; Erythrocyte Indices; Female; Folic Acid; Folic Acid Deficiency; Hemoglobins; Humans; Iron; Male; Middle Aged; Mouth Diseases; Parietal Cells, Gastric; Taiwan; Vitamin B 12; Vitamin B 12 Deficiency; Young Adult

Megaloblastic anemias are a subgroup of macrocytic anemias, in which distinctive morphologic abnormalities occur in red cell precursors in bone marrow, namely megaloblastic erythropoiesis. Of the many causes of megaloblastic anemia, the most common are disorders resulting from cobalamin or folate deficiency. The clinical symptoms are weakness, fatigue, shortness of breath and neurologic abnormalities. The presence of oral signs and symptoms, including glossitis, angular cheilitis, recurrent oral ulcer, oral candidiasis, diffuse erythematous mucositis and pale oral mucosa offer the dentist an opportunity to participate in the diagnosis of this condition. Early diagnosis is important to prevent neurologic signs, which could be irreversible. The aim of this paper is to describe the oral changes in a patient with megaloblastic anemia caused by a dietary deficiency of cobalamin.

Topics: Adult; Anemia, Megaloblastic; Female; Humans; Hydroxocobalamin; Mouth Diseases; Treatment Outcome; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin B Complex

The early stages of tissue B12 or folate deficiency often cause diagnostic problems. In this report, the levels of serum cobalamin, folate, methylmalonic acid (MMA) and total homocysteine (tHcy), and their relationships with clinical findings and reported symptoms in a representative random population sample are presented.. Cohort study.. A general central Swedish population 70 years or older.. A 20% random sample of persons 70 years or older in a defined geographical area were invited to a survey. A total of 235 (85%) persons responded, of whom 161 had no interfering diseases or medication. Blood specimens for serum cobalamin, folate, MMA and tHcy analyses were drawn.. Presence of anaemic, gastrointestinal, neurological and psychiatric symptoms, obtained by questionnaire, and vibration sense measurement and findings at a physical and Mini Mental State Examination.. Among a large number of symptoms and clinical findings that traditionally have been linked to vitamin B12 or folate tissue deficiency, only changes in the tongue mucosa and mouth angle stomatitis turned out to be significantly associated with abnormal serum tHcy and serum folate levels. There were no relationships to serum cobalamin and serum MMA.. Changes in the oral mucosa were the only signs and symptoms found in this study, indicating that these may be the very early markers of metabolic defects. The traditional symptoms of vitamin deficiency may appear later in the course.

Topics: Aged; Atrophy; Cohort Studies; Female; Folic Acid; Health Surveys; Homocysteine; Humans; Male; Methylmalonic Acid; Mouth Diseases; Mouth Mucosa; Stomatitis; Tongue; Vitamin B 12; Vitamin B 12 Deficiency

The oral manifestations of glossitis, stomatitis and mucosal ulceration in vitamin B12 deficiency have long been recognised. These oral changes may occur in the absence of symptomatic anaemia or of macrocytosis. The aim of this paper is to describe a retrospective study of the wide range of oral signs and symptoms reported by 14 patients found to have a previously undiagnosed vitamin B12 deficiency. None of the patients described in this study had generalised symptoms sufficiently advanced to arouse suspicions of vitamin B12 deficiency. The essential criteria for the diagnosis of pernicious anaemia are also discussed.

Topics: Anemia; Anemia, Macrocytic; Anemia, Pernicious; Burning Mouth Syndrome; Cheilitis; Female; Glossalgia; Glossitis; Humans; Male; Mouth Diseases; Mouth Mucosa; Retrospective Studies; Stomatitis; Stomatitis, Denture; Ulcer; Vitamin B 12; Vitamin B 12 Deficiency

The hematologic status of 144 consecutive patients in the United Kingdom with oral disease (69 with recurrent aphthous stomatitis; 75 with other disorders) was examined in an attempt to resolve the controversy as to whether levels of hemoglobin, blood cell numbers and indices, and blood film are adequate in the screening of patients with aphthae. Though hemoglobin levels and red blood cell indices were normal in patients with recurrent aphthous stomatitis, there was still a small minority of patients with deficiencies of iron (low serum ferritin), folate (low red blood cell levels), or vitamin B12 (low serum levels) that would have remained undetected. Full hematologic screening of patients with recurrent aphthous stomatitis thus reveals latent deficiency states, at least in some parts of the world, and there are good reasons for elucidating the underlying cause and correcting these deficiencies, particularly vitamin B12 deficiency. Therapeutic studies are now required to establish the frequency with which deficiencies actually predispose to recurrent aphthous stomatitis.

Topics: Adult; Erythrocyte Indices; Erythrocytes; Female; Ferritins; Folic Acid; Humans; Male; Mouth Diseases; Recurrence; Stomatitis, Aphthous; Vitamin B 12

Topics: Adult; Anemia, Macrocytic; Anemia, Pernicious; Bone Marrow Examination; Female; Humans; Mouth Diseases; Schilling Test; Vitamin B 12; Vulvar Diseases

A full haematology screen was carried out on 398 patients under investigation for recurrent oral ulceration or stomatitis. Thirty-three patients were found to have lowered serum folate and/or red cell folate levels without iron deficiency. Of these only six were found to have a mean corpuscular volume (MCV) outside normal limits or to have recognisable erythrocyte abnormalities. No correlation was found between serum or red cell folate levels and the MCV. Eighteen patients were found to have lowered serum B12 levels without iron deficiency, of these seven were found to have a MCV outside normal limits. A significant negative correlation was found between serum B12 levels and the MCV. It is concluded that haematological screening in these cases should include estimations of serum folate, red cell folate and serum B12 levels even in the face of an apparently normal peripheral blood film.

Topics: Erythrocyte Indices; Female; Folic Acid; Hematologic Tests; Humans; Male; Mouth Diseases; Stomatitis; Ulcer; Vitamin B 12

Topics: Adolescent; Adult; Aged; Anemia, Hypochromic; Binding Sites; Blood Sedimentation; Diagnosis, Differential; Female; Folic Acid; Folic Acid Deficiency; Humans; Iron; Iron Deficiencies; Male; Middle Aged; Mouth Diseases; Prospective Studies; Recurrence; Stomatitis, Aphthous; Ulcer; Vitamin B 12; Vitamin B 12 Deficiency

The objective of this article is to familiarize the dentist with clinical signs and laboratory methods used in diagnosing nutritional deficiencies, and to indicate which laboratory methods may be useful to the clinician in cases of suspected nutritional deficiency. It should be noted that the suggested laboratory methods were selected on the basis of their applicability for the clinical situation as well as their reliability as indicators of nutritional status. Therefore these suggested methods of choice may not in every instance be the most accurate of all indicators of nutritional status for a particular nutrient. The dentist who wishes to utilize one of the laboratory methods has a number of options. He can take the appropriate sample in his office, or refer the patient directly to a clinical laboratory for the simpler analyses, or refer his patient to a physician for appropriate metabolic testing. The first option may be more appropriate for the dentist practicing in areas where a clinical laboratory is not within reasonable distance. In this instance the dentist should contact the laboratory for specific information, such as sample volume and special instructions for taking, handling, and shipping the sample. The second option is available to the dentist practicing in an urban area where clinical laboratory facilities are readily available. Finally, the dentist should work in conjunction with a physician when complex metabolic testing is required.

Topics: Anthropometry; Ascorbic Acid; Blood Proteins; Calcium; Deficiency Diseases; Gingival Diseases; Humans; Iron; Lip Diseases; Medical History Taking; Mouth Diseases; Mouth Mucosa; Riboflavin; Thiamine; Tongue Diseases; Vitamin A; Vitamin B 12; Vitamin D; Vitamin E

Topics: Ascorbic Acid; Humans; Injections, Intramuscular; Male; Middle Aged; Mouth Diseases; Mumps; Nicotinic Acids; Otorhinolaryngologic Diseases; Pyridoxine; Thiamine; Vitamin B 12; Vitamins