DOI:

10.37988/1811-153X_2022_2_34

Association of recurrent aphthous stomatitis with an iron, vitamin B12 and folic acid deficiency: A clinical case

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Authors

  • L.A. Aksamit 1, PhD in Medical Sciences, associate professor of the Pain management in dentistry Department
    ORCID: 0000-0002-1911-525X
  • G.S. Runova 1, PhD in Medical Sciences, associate professor of the Periodontology Department
    ORCID: 0000-0002-3545-6353
  • V.V. Luzina 1, PhD in Medical Sciences, associate professor of the Maxillofacial and plastic surgery Department
    ORCID: 0000-0002-3159-6818
  • M.A. Tsvetkova 1, PhD in Medical Sciences, dentist
    ORCID: 0000-0003-2183-1623
  • A.A. Babanina 1, dentist
  • 1 Moscow State University of Medicine and Dentistry, 127473, Moscow, Russia

Abstract

Recurrent aphthous stomatitis (RAS) is a common disease of the oral mucosa. The etiopathogenesis of RAS is associated with various factors that change the immunological response. Many authors connected RAS development with anemia due to the vitamin B12, folic acid and iron deficiency. The aim of the study is clinical observation and examination of patients with RAS in order to identify vitamin B12, iron and folic acid deficiency.
Material and methods.
12 patients with a clinical picture of RAS (6 women and 6 men aged 20-44 years) were examined for possible anemia and blood concentration of vitamin B12, folic acid and iron.
Results.
Blood tests showed signs of anemia in 7 people due to iron deficiency (in 3), vitamin B12 (in 3) and folic acid (in 1). In 5 patients, there were no abnormalities in blood counts. All patients with RAS and anemia were referred to a gastroenterologist. All patients received local symptomatic treatment, including analgesics, anti-inflammatory and epithelial agents. Discussion. In the literature, the association of RAS with gastrointestinal tract diseases (celiac disease, Crohn’s disease, etc.) was most often noted, which is currently explained by impaired absorption of substances such as iron, vitamins B1, B2, B6, B12, folic acid.
Conclusion.
A dentist treating patients with RAS, should include a general clinical blood test and tests for the content of vitamin B12, folic acid and iron in the diagnostic plan. If anemia is detected, patients should be referred to gastroenterologist and hematologist. Dental treatment is symptomatic.

Key words:

recurrent aphthous stomatitis, anemia, folic acid deficiency, vitamin B12 deficiency, iron deficiency

For Citation

[1]
Aksamit L.A., Runova G.S., Luzina V.V., Tsvetkova M.A., Babanina A.A. Association of recurrent aphthous stomatitis with an iron, vitamin B12 and folic acid deficiency: A clinical case. Clinical Dentistry (Russia).  2022; 25 (2): 34—37. DOI: 10.37988/1811-153X_2022_2_34

References

  1. Akbarov A.N., Ziyadullaeva N.S., Irismetova B.D. Chronic recurrent aphthous stomatitis: Modern approaches to treatment. Re-health Journal. 2021; 2 (10): 196—202 (In Russ.). eLIBRARY ID: 46227940
  2. Belenguer-Guallar I., Jiménez-Soriano Y., Claramunt-Lozano A. Treatment of recurrent aphthous stomatitis. A literature review. J Clin Exp Dent. 2014; 6 (2): e168—74. PMID: 24790718
  3. Tarakji B., Gazal G., Al-Maweri S.A., Azzeghaiby S.N., Alaizari N. Guideline for the diagnosis and treatment of recurrent aphthous stomatitis for dental practitioners. J Int Oral Health. 2015; 7 (5): 74—80. PMID: 26028911
  4. Queiroz S.I.M.L., Silva M.V.A.D., Medeiros A.M.C., Oliveira P.T., Gurgel B.C.V., Silveira É.J.D.D. Recurrent aphthous ulceration: an epidemiological study of etiological factors, treatment and differential diagnosis. An Bras Dermatol. 2018; 93 (3): 341—346. PMID: 29924245
  5. Chiang C.P., Yu-Fong Chang J., Wang Y.P., Wu Y.H., Wu Y.C., Sun A. Recurrent aphthous stomatitis Etiology, serum autoantibodies, anemia, hematinic deficiencies, and management. J Formos Med Assoc. 2019; 118 (9): 1279—1289. PMID: 30446298
  6. Shah K., Guarderas J., Krishnaswamy G. Aphthous stomatitis. Ann Allergy Asthma Immunol. 2016; 117 (4): 341—343. PMID: 27742082
  7. Edgar N.R., Saleh D., Miller R.A. Recurrent aphthous stomatitis: A review. J Clin Aesthet Dermatol. 2017; 10 (3): 26—36. PMID: 28360966
  8. Xu K., Zhou C., Huang F., Duan N., Wang Y., Zheng L., Wang X., Wang W. Relationship between dietary factors and recurrent aphthous stomatitis in China: a cross-sectional study. J Int Med Res. 2021; 49 (5): 3000605211017724. PMID: 34057842
  9. Cui R.Z., Bruce A.J., Rogers R.S. 3rd Recurrent aphthous stomatitis. Clin Dermatol. 2016; 34 (4): 475—81. PMID: 27343962
  10. Borovskiy E.V., Mashkilleyson A.L. Oral cavity and lips mucosa diseases. Moscow: Medicine, 1984. 400 p. (In Russ.).
  11. Sun A., Chen H.M., Cheng S.J., Wang Y.P., Chang J.Y., Wu Y.C., Chiang C.P. Significant association of deficiencies of hemoglobin, iron, vitamin B12, and folic acid and high homocysteine level with recurrent aphthous stomatitis. J Oral Pathol Med. 2015; 44 (4): 300—5. PMID: 25048341
  12. Chang J.Y., Wang Y.P., Wu Y.C., Cheng S.J., Chen H.M., Sun A. Hematinic deficiencies and anemia statuses in oral mucosal disease patients with folic acid deficiency. J Formos Med Assoc. 2015; 114 (9): 806—12. PMID: 26187724
  13. Neville B.W., Damm D.D., Allen C.M., Chi A.C. Oral and maxillofacial pathology. Philadelphia: Elsevier, 2016. Pp. 303—310.
  14. Zakharova I.N., Dmitrieva Yu.A., Dzebisova F.S. Celiac disease and associated diseases. Russian Bulletin of Perinatology and Pediatrics. 2014; 3: 44—49 (In Russ.). eLIBRARY ID: 21649595
  15. Ferraz E.G., Campos Ede J., Sarmento V.A., Silva L.R. The oral manifestations of celiac disease: information for the pediatric dentist. Pediatr Dent. 2012; 34 (7): 485—8. PMID: 23265166
  16. Wierdsma N.J., van Bokhorst-de van der Schueren M.A., Berkenpas M., Mulder C.J., van Bodegraven A.A. Vitamin and mineral deficiencies are highly prevalent in newly diagnosed celiac disease patients. Nutrients. 2013; 5 (10): 3975—92. PMID: 24084055
  17. Al-Zahrani M.S., Alhassani A.A., Zawawi K.H. Clinical manifestations of gastrointestinal diseases in the oral cavity. Saudi Dent J. 2021; 33 (8): 835—841. PMID: 34938023
  18. Rashid M., Zarkadas M., Anca A., Limeback H. Oral manifestations of celiac disease: a clinical guide for dentists. J Can Dent Assoc. 2011; 77: b39. PMID: 21507289

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Received

April 20, 2022

Published on

June 1, 2022