Screening for Haematinic Deficiencies in Patients With Recurrent Aphthous Stomatitis

Abstract

r SUMMARY To resolve the conflict among published reports as to the value of screening for haematinic deficiencies in patients with recurrent aphthous stomatitis, we evaluated 102 such patients. Venous blood was sampled for a complete blood cell count and measurements of serum iron, serum iron-binding capacity and capacity saturation, serum folate, and serum vitamin BM. Of the 40 patients deficient In iron or folate, 6 were anaemic, 23 were deficient in iron, and 22 were deficient in folate; 5 were deficient in both iron and folate. The discriminating value of the complete blood cell count between the 62 nondeficient and 40 deficient patients was low. Among the 70 patients evaluated 6 years after entry into the study, 24 (60%) of the 40 nondeficient patients and 23 (77%) of the 30 deficient patients were in remission or improved. The results of this study confirm the advisability of screening for haematinic deficiencies of iron, folate, and vitamin B\2 and also suggest that replacement therapy in deficient patients is beneficiai.

Number VI Recurrent aphthous stomatitis

“…Haematinic (iron, folic acid or vitamin B 12 ) deficiencies may be twice as common in some groups of patients with RAS as in healthy control subjects (Wray et al , 1975; Challacombe et al , 1977a, 1983; Hutcheon et al , 1978; Tyldesley, 1983; Rogers and Hutton, 1986; Field et al , 1987; Porter et al , 1988). About 20% of patients with RAS may have a haematinic deficiency, although one US study did not report any haematinic problem (Olson et al , 1982).…”

“…RAS-like ulceration can occur in Behcet's disease, however patients with the latter have multisystem disease, particularly affecting (Mittal et al, 1985;Schreiner and Jorizzo, 1987;Arbesfeld and Kurban, 1988;Jankowski et al, 1992;Stratigos et al, 1992). Haematinic (iron, folic acid or vitamin B 12 ) deficiencies may be twice as common in some groups of patients with RAS as in healthy control subjects (Wray et al, 1975;Challacombe et al, 1977aChallacombe et al, , 1983Hutcheon et al, 1978;Tyldesley, 1983;Rogers and Hutton, 1986;Field et al, 1987;Porter et al, 1988). About 20% of patients with RAS may have a haematinic deficiency, although one US study did not report any haematinic problem (Olson et al, 1982).…”

Recurrent Aphthous Stomatitis

“…In several studies, hematinic (iron, folic acid, or vitamin B 1 2) deficiencies have been demonstrated to be twice as common in RAS patients than in controls (Wray et al, 1975;Challacombe et al, 1977aChallacombe et al, , 1983Hutcheon et al, 1978;Tyldesley, 1983;Rogers and Hutton, 1986;Field et al, 1987;Porter et al, 1988). About 20% of patients with RAS may have a hematinic deficiency, though one US study did not report any hematinic problem (Olsen et al, 1982).…”

“…Individuals with RAS possibly related to foodstuffs may occasionally benefit from dietary alterations (Spouge and Diamond, 1963;Eversole et al, 1983;Hay and Reade, 1984), while hematinic replacement can be of value in patients with hematinic deficiency of unknown cause (Wray et al, 1975;Rogers and Hutton, 1986;Porter et al, 1992a). Zinc sulphate therapy is not effective (Wray, 1982).…”

Oral ulceration in HIV infection: Investigation and pathogenesis

“…Of the 75 patients, 66% had RAU lesions of the more severe herpetiform or major types. Estimates in the literature from before the advent of the AIDS epidemic suggest that minor RAU comprised about 80% of all cases, whereas major and herpetiform RAU together comprised only about 20% (Lehner 1977;Greenspan, 1983;Rogers and Hutton, 1986;Hutton and Rogers, 1987). Given that the OAC Clinic specializes in unusual oral problems, seeing persons with severe RAU is not unexpected.…”