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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., Competing Interests: Declaration of Competing Interest The authors have no conflicts of interest relevant to this article., (Copyright © 2020 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.)

Background/purpose: Burning mouth syndrome (BMS) is characterized by burning sensation of the oral mucosa in the absence of clinically apparent oral mucosal alterations. This study evaluated the anemia, hematinic deficiencies, hyperhomocysteinemia, and serum gastric parietal cell antibody (GPCA) positivity in 884 BMS patients., Methods: The blood hemoglobin (Hb) and serum iron, vitamin B12, folic acid, homocysteine, GPCA levels in 884 BMS patients were measured and compared with the corresponding levels in 442 age- and sex-matched healthy control subjects., Results: We found that 175 (19.8%), 143 (16.2%), 42 (4.8%), 20 (2.3%), 170 (19.2%), and 109 (12.3%) BMS patients had blood Hb, serum iron, vitamin B12, and folic acid deficiencies, hyperhomocysteinemia, and serum GPCA positivity, respectively. Moreover, 884 BMS patients had significantly higher frequencies of blood Hb and serum iron, vitamin B12, and folic acid deficiencies, hyperhomocysteinemia, and serum GPCA positivity than 442 healthy control subjects (all P-values < 0.005). Of 175 anemic BMS patients, 95 had normocytic anemia, 27 had thalassemia trait-induced anemia, 21 had iron deficiency anemia, 15 had pernicious anemia, 15 had macrocytic anemia other than pernicious anemia, and 2 had microcytic anemia other than iron deficiency anemia and thalassemia trait-induced anemia. Burning sensation of oral mucosa (100.0%), dry mouth (48.1%), numbness of oral mucosa (30.7%), and dysfunction of taste (16.7%) were the four common symptoms in 884 BMS patients., Conclusion: BMS patients have significantly higher frequencies of blood Hb and serum iron, vitamin B12, and folic acid deficiencies, hyperhomocysteinemia, and serum GPCA positivity than healthy control subjects., Competing Interests: Declaration of Competing Interest The authors have no conflicts of interest relevant to this article., (Copyright © 2019 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.)

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., (Copyright © 2019 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.)

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., Competing Interests: Declaration of Competing Interest The authors have no conflicts of interest relevant to this article., (Copyright © 2019 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.)

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., (Copyright © 2019 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.)

Background/purpose: Microcytosis is defined as having mean corpuscular volume (MCV) < 80 fL. This study evaluated whether 79 atrophic glossitis (AG) patients with microcytosis and 985 AG patient without microcytosis had higher frequencies of anemia, hematinic deficiencies, hyperhomocysteinemia, and serum gastric parietal cell antibody (GPCA) positivity than 532 healthy control subjects., Methods: Complete blood count, serum iron, vitamin B12, folic acid, homocysteine, and serum GPCA levels in 79 AG patients with microcytosis, 985 AG patient without microcytosis, and 532 healthy control subjects were measured and compared., Results: We found that 69.6%, 43.0%, 5.1%, 3.8%, 11.4%, and 22.8% of 79 AG patients with microcytosis and 14.9%, 14.8%, 5.3%, 2.1%, 12.0%, and 27.0% of 985 AG patients without microcytosis were diagnosed as having blood hemoglobin, iron, vitamin B12, and folic acid deficiencies, hyperhomocysteinemia, and serum GPCA positivity, respectively. Both 79 AG patients with microcytosis and 985 AG patients without microcytosis had significantly higher frequencies of blood hemoglobin, iron, vitamin B12, and folic acid deficiencies, hyperhomocysteinemia, and serum GPCA positivity than 532 healthy control subjects (all P-values < 0.01). Moreover, 79 AG patients with microcytosis had significantly higher frequencies of blood hemoglobin and iron deficiencies than 985 AG 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 AG patients with or without microcytosis than in healthy control subjects. AG patients with microcytosis have significantly higher frequencies of blood hemoglobin and iron deficiencies than AG patients without microcytosis., (Copyright © 2019. Published by Elsevier B.V.)

Recurrent aphthous stomatitis (RAS) is one of the most common oral mucosal diseases characterized by recurrent and painful ulcerations on the movable or nonkeratinized oral mucosae. Clinically, three types of RAS, namely minor, major, and herpetiform types, can be identified. RAS more commonly affects labial mucosa, buccal mucosa, and tongue. Previous studies indicate that RAS is a multifactorial T cell-mediated immune-dysregulated disease. Factors that modify the immunologic responses in RAS include genetic predisposition, viral and bacterial infections, food allergies, vitamin and microelement deficiencies, systemic diseases, hormonal imbalance, mechanical injuries, and stress. Our previous study found the presence of serum gastric parietal cell antibody, thyroglobulin antibody, and thyroid microsomal antibody in 13.0%, 19.4%, and 19.7% of 355 RAS patients, respectively. We also found anemia, serum iron, vitamin B12, and folic acid deficiencies, and hyperhomocysteinemia in 20.9%, 20.1%, 4.8%, 2.6%, and 7.7% of 273 RAS patients, respectively. Therefore, it is very important to examine the complete blood count, serum autoantibody, hematinic, and homocysteine levels in RAS patients before we start to offer treatments for RAS. Because RAS is an immunologically-mediated disease, topical and systemic corticosteroid therapies are the main treatments of choice for RAS., (Copyright © 2018 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.)

Background/purpose: Our previous study found that 304 of 1064 atrophic glossitis (AG) patients have thyroglobulin antibody (TGA) positivity and/or thyroid microsomal antibody (TMA) positivity but without gastric parietal cell antibody positivity (GPCA־TGA + /TMA + AG patients). This study mainly assessed whether the serum TGA/TMA positivity was significantly associated with anemia, hematinic deficiencies, and hyperhomocysteinemia in GPCA־TGA + /TMA + AG patients., Methods: The mean blood hemoglobin (Hb), iron, vitamin B12, folic acid, and homocysteine levels were measured and compared between 304 GPCA־TGA + /TMA + AG patients and 476 GPCA-negative, TGA-negative, and TMA-negative AG patients (GPCA־TGA־TMA־AG patients) or 532 healthy control subjects., Results: We found significantly lower MCV and lower mean blood Hb and iron levels as well as significantly greater frquencies of microcytosis, macrocytosis, blood Hb, iron, vitamin B12, and folic acid deficiencies and hyperhomocysteinemia in 304 GPCA־TGA + /TMA + AG patients than in 532 healthy control subjects. However, no significant differences in the MCV and mean blood Hb, iron, vitamin B12, folic acid, and homocysteine leve1s as well as no significant differences in the frequencies of microcytosis, macrocytosis, blood Hb, iron, and folic acid deficiencies, and hyperhomocysteinemia were discovered between 304 GPCA־TGA + /TMA + AG patients and 476 GPCA־TGA־TMA־AG patients. The 304 GPCA־TGA + /TMA + AG patients had a significantly greater frquency of serum vitamin B12 deficiency than 476 GPCA־TGA־TMA־AG patients., Conclusion: The disease of AG itself plays a significant role in causing anemia, hematinic deficiencies, and hyperhomocysteinemia in GPCA־TGA + /TMA + AG patients. However, the serum TGA/TMA-positivity is not significantly associated with anemia, serum iron and folic acid deficiencies, and hyperhomocysteinemia in GPCA־TGA + /TMA + AG patients., (Copyright © 2019 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.)

Background/purpose: Our previous study found that 177 of 1064 atrophic glossitis (AG) patients have serum gastric parietal cell antibody (GPCA) positivity only (so-called GPCA + AG patients). This study assessed whether serum GPCA positivity or AG itself was a significant factor causing hematinic deficiencies and hyperhomocysteinemia in GPCA + AG or GPCA-negative, thyroglobulin antibody (TGA)-negative, and thyroid microsomal antibody (TMA)-negative AG (GPCA־TGA־TMA־AG) patients., Methods: The mean blood hemoglobin (Hb), iron, vitamin B12, folic acid, and homocysteine levels were measured and compared between any two of three groups of 177 GPCA + AG patients, 476 GPCA־TGA־TMA־AG patients, and 532 healthy control subjects., Results: GPCA + AG patients had significantly lower mean blood Hb and iron (for women only) levels and a significantly higher mean serum homocysteine level than healthy control subjects. Moreover, GPCA + AG patients had significantly greater frequencies of blood Hb, iron, and vitamin B12 deficiencies and hyperhomocysteinemia than healthy control subjects. GPCA + AG patients have a lower mean serum vitamin B12 level and a significantly higher mean serum homocysteine level as well as significantly greater frequencies of vitamin B12 deficiency and hyperhomocysteinemia than GPCA־TGA־TMA־AG patients. Moreover, GPCA־TGA־TMA־AG patients did have significantly lower mean blood Hb and iron levels and significantly greater frequencies of blood Hb, iron, vitamin B12, and folic acid deficiencies and hyperhomocysteinemia than healthy control subjects., Conclusion: The GPCA is a major factor causing vitamin B12 deficiency and hyperhomocyteinemia in GPCA + AG patients. AG itself does play a significant role in causing anemia, hematinic deficiencies, and hyperhomocysteinemia in both GPCA + AG and GPCA־TGA־TMA־AG patients., (Copyright © 2019. Published by Elsevier B.V.)

Background/purpose: Approximately 27% of atrophic glossitis (AG) patients have the serum gastric parietal cell antibody (GPCA) positivity. This study assessed whether the serum GPCA or AG itself was a significant factor causing anemia, hematinic deficiencies, and hyperhomocysteinemia in GPCA-positive AG (GPCA + AG) and GPCA-negative AG (GPCA - AG) patients., Methods: The mean corpuscular volume (MCV) and mean blood hemoglobin (Hb), iron, vitamin B12, folic acid, and homocysteine levels were measured and compared between any two of three groups of 284 GPCA + AG, 780 GPCA - AG patients, and 532 healthy control subjects., Results: Both 284 GPCA + AG and 780 GPCA - AG patients had significantly higher frequencies of microcytosis, macrocytosis, blood Hb, iron, vitamin B12, and folic acid deficiencies, and hyperhomocysteinemia than 532 healthy control subjects. Moreover, 284 GPCA + AG patients had significantly higher frequencies of macrocytosis, vitamin B12 deficiency, and hyperhomocysteinemia than 780 GPCA - AG patients. Sixty-three (22.2%) of 284 GPCA + AG patients and 139 (17.8%) of 780 GPCA - AG patients had anemia. The normocytic anemia (42.9%), pernicious anemia (34.9%), and iron deficiency anemia (15.9%) were the three most common types of anemia in the 63 anemic GPCA + AG patients. Moreover, the normocytic anemia (64.8%), iron deficiency anemia (14.4%), and thalassemia trait-induced anemia (13.7%) were the three most common types of anemia in 139 anemic GPCA - AG patients., Conclusion: The disease of AG itself is a significant factor causing anemia, hematinic deficiencies, and hyperhomocysteinemia in both GPCA + AG and GPCA - AG patients. The serum GPCA also plays a significant role in causing macrocytosis, vitamin B12 deficiency, and hyperhomocysteinemia in GPCA + AG patients., (Copyright © 2018 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.)

Background/purpose: Atrophic glossitis (AG) patients are prone to have anemia, hematinic deficiencies, hyperhomocysteinemia, and serum gastric parietal cell antibody (GPCA) positivity. This study evaluated whether 1064 AG patients had significantly higher frequencies of anemia, hematinic deficiencies, hyperhomocysteinemia, and serum GPCA positivity than 532 healthy control subjects., Methods: The complete blood count, serum iron, vitamin B12, folic acid, homocysteine, and serum GPCA levels in 1064 AG patients and 532 age- and sex-matched healthy control subjects were measured and compared., Results: We found that 7.4%, 3.9%, 19.0%, 16.9%, 5.3%, 2.3%, 11.9%, and 26.7% of 1064 AG patients were diagnosed as having microcytosis, macrocytosis, hemoglobin, iron, vitamin B12, and folic acid deficiencies, hyperhomocysteinemia, and serum GPCA positivity, respectively. Moreover, 1064 AG patients had significantly higher frequencies of microcytosis, macrocytosis, hemoglobin, iron, vitamin B12, and folic acid deficiencies, hyperhomocysteinemia, and serum GPCA positivity than 532 healthy control subjects (all P-values < 0.005). Of the 202 anemic AG patients, 22 had pernicious anemia, eight had macrocytic anemia rather than pernicious anemia, 117 had normocytic anemia, 30 had iron deficiency anemia, and 21 had thalassemia trait-induced anemia, and four had microcytic anemia rather than iron deficiency anemia and thalassemia trait-induced anemia., Conclusion: There are significantly higher frequencies of anemia, serum iron, vitamin B12, and folic acid deficiencies, hyperhomocysteinemia, and serum GPCA positivity in AG patients than in healthy control subjects. The normocytic anemia and iron deficiency anemia are the two most common types of anemia in our 1064 AG patients., (Copyright © 2018. Published by Elsevier B.V.)

Background/purpose: Behcet's disease (BD) patients may have one or more hematinic deficiencies. This study evaluated whether there were significantly higher frequencies of hemoglobin, iron, vitamin B12, and folic acid deficiencies and of hyperhomocysteinemia in BD patients., Methods: The blood hemoglobin, iron, vitamin B12, folic acid, and homocysteine concentrations in 63 BD patients were measured and compared with the corresponding levels in 126 age- and sex-matched healthy control subjects., Results: We found that 30.2%, 34.9%, 6.3%, 6.3%, and 14.3% of 63 BD patients had hemoglobin, iron, vitamin B12, and folic acid deficiencies and hyperhomocysteinemia, respectively. Both 63 BD and 19 major-typed RAS/BD patients had significantly higher frequencies of hemoglobin, iron, vitamin B12, and folic acid deficiencies and of hyperhomocysteinemia than 126 healthy control subjects (all P-values < 0.05). Moreover, 44 minor-typed RAS/BD patients had significantly higher frequencies of hemoglobin and iron deficiencies than 126 healthy control subjects (both P-values < 0.001). Of the 19 anemic BD patients, one had pernicious anemia, one had macrocytic anemia, 12 had normocytic anemia, four had iron deficiency anemia, and one had thalassemia trait-induced anemia., Conclusion: There are significantly higher frequencies of hemoglobin, iron, vitamin B12, and folic acid deficiencies and of hyperhomocysteinemia in BD patients. The normocytic anemia is the most common type of anemia in our 63 BD patients. We suggest that supplementations of vitamin BC capsules plus deficient vitamin B12 and/or folic acid may reduce the abnormally high serum homocysteine level to a relatively lower level in BD patients with hyperhomocysteinemia., (Copyright © 2018. Published by Elsevier B.V.)

Background/purpose: 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)., Methods: 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., Results: Compared with GPCA-/microcytosis, the positive counterparts presented with a lower mean serum vitamin B12 level (marginal significance), significantly higher mean RDW and serum homocysteine level, and significantly greater frequencies of vitamin B12 deficiency and high homocysteine level. GPCA-/microcytosis patients had significantly greater frequencies of hemoglobin, iron, vitamin B12, and folic acid deficiencies and of RBC count > 5 × 10 12 /L than healthy controls. Moreover, 19 of 30 GPCA+/microcytosis patients and 143 of 210 GPCA-/microcytosis patients had anemia, with iron deficiency anemia being the most common type, followed by thalassemia trait-induced anemia and microcytic anemia due to other causes., Conclusion: 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., (Copyright © 2017. Published by Elsevier B.V.)

Background/purpose: 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., Methods: 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., Results: Microcytosis patients had significantly lower mean Hb, iron, and folic acid levels as well as significantly higher mean RBC count and RBC distribution width than healthy control individuals. Microcytosis patients also had significantly greater frequencies of Hb, iron, vitamin B12, and folic acid deficiencies as well as of RBC number > 5 × 10 12 /L, and abnormally high homocysteine levels than healthy control individuals. Moreover, 162 (67.5%) of the 240 microcytosis patients had anemia. Of 162 anemic microcytosis patients, 87 (53.7%) had iron deficiency anemia, 61 (37.7%) had thalassemia trait (TT)-induced anemia, and 14 (8.6%) had other microcytic anemia., Conclusion: 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., (Copyright © 2017. Published by Elsevier B.V.)

Background/purpose: Approximately 13% of recurrent aphthous stomatitis (RAS) patients have serum anti-gastric parietal cell antibody (GPCA) positivity. This study assessed whether serum GPCA or RAS itself was a significant factor causing hematinic deficiencies and anemia statuses in GPCA-positive RAS (GPCA+/RAS) and all autoantibodies-negative RAS (Abs-/RAS) patients., Methods: The mean corpuscular volume (MCV) and mean blood hemoglobin (Hb), iron, vitamin B12, and folic acid levels were measured and compared between any two of three groups of 31 GPCA+/RAS patients, 240 Abs-/RAS patients, and 342 healthy control subjects., Results: GPCA+/RAS patients had significantly lower mean Hb and serum iron level (for women only) as well as significantly greater frequencies of Hb, iron, and vitamin B12 deficiencies than healthy control subjects. Moreover, GPCA+/RAS patients had a significantly higher MCV and a significantly greater frequency of vitamin B12 deficiency than Abs-/RAS patients. Furthermore, Abs-/RAS patients did have significantly lower mean Hb, MCV, iron, and folic acid levels and significantly greater frequencies of Hb, iron, vitamin B12, and folic acid deficiencies than healthy control subjects. Of 31 GPCA+/RAS patients, 3 (9.7%) had PA, 6 (19.4%) had vitamin B12 deficiency, and 3 (9.7%) had macrocytosis. Moreover, normocytic anemia (54.0%) and iron deficiency anemia (26.4%) are the two more common types of anemia in our RAS patients., Conclusions: We conclude that serum GPCA plays a significant role in causing vitamin B12 deficiency and high MCV in GPCA+/RAS patients. RAS itself does play a significant role in causing anemia and hematinic deficiencies in both GPCA+/RAS and Abs-/RAS patients., (Copyright © 2016. Published by Elsevier B.V.)

Background/purpose: Some of recurrent aphthous stomatitis (RAS) patients had concomitant atrophic glossitis (AG). This study assessed whether RAS patients with AG (AG+/RAS patients) or without AG (AG-/RAS patients) had anemia and hematinic deficiencies and to evaluate whether RAS combined with AG or RAS itself was a significant factor causing anemia and hematinic deficiencies in AG+/RAS or AG-/RAS patients, respectively., Methods: The mean corpuscular volume (MCV) and mean blood hemoglobin (Hb), iron, vitamin B12, and folic acid levels were measured and compared between any two of three groups of 160 AG+/RAS patients, 195 AG-/RAS patients, and 355 healthy control subjects., Results: Both AG+/RAS and AG-/RAS patients had significantly lower mean Hb, iron, and vitamin B12 levels as well as significantly greater frequencies of Hb, iron, vitamin B12, and folic acid deficiencies than healthy control subjects. Moreover, AG+/RAS patients had significantly lower mean Hb and serum iron level (for women only) and significantly greater frequencies of Hb and iron deficiencies than AG-/RAS patients. Of 69 anemia AG+/RAS patients, 30 (43.5%) had normocytic anemia and 23 (33.3%) had iron deficiency anemia. Of 38 anemia AG-/RAS patients, 26 (68.4%) had normocytic anemia and 5 (13.2%) had iron deficiency anemia., Conclusion: We conclude that some of AG+/RAS or AG-/RAS patients do have anemia and hematinic deficiencies and AG+/RAS patients do have severer anemia statuses and iron deficiency than AG-/RAS patients. RAS combined with AG or RAS itself does play a significant role in causing anemia and hematinic deficiencies in AG+/RAS or AG-/RAS patients, respectively., (Copyright © 2016. Published by Elsevier B.V.)

Background/purpose: Erosive oral lichen planus (EOLP) patients with desquamative gingivitis (DG) are sometimes encountered in our oral mucosal disease clinic. This study assessed hematinic deficiencies and anemia statuses in antigastric parietal cell antibody (GPCA)-positive EOLP patients with DG (GPCA + /DG + /EOLP patients)., Methods: The blood hemoglobin, iron, vitamin B12, folic acid, and homocysteine concentrations and serum GPCA levels in 92 GPCA + /DG + /EOLP patients and 184 age- and sex-matched healthy controls were measured and compared between the two groups., Results: We found that 27 (29.3%), 16 (17.4%), and 27 (29.3%) of 92 GPCA + /DG + /EOLP patients had hemoglobin (men < 13 g/dL and women < 12 g/dL), iron (< 60 μg/dL), and vitamin B12 (< 200 pg/mL) deficiencies, respectively. Moreover, 37 (40.2%) of 92 GPCA + /DG + /EOLP patients had an abnormally high blood homocysteine level (> 12.1μM). GPCA + /DG + /EOLP patients had a significantly higher frequency of hemoglobin, iron, or vitamin B12 deficiency and an abnormally high blood homocysteine level than healthy control individuals (all p < 0.001). Of 27 anemic GPCA + /DG + /EOLP patients, 13 (48.2%) had pernicious anemia, five (18.5%) had iron deficiency anemia, one (3.7%) had thalassemia trait, and the remaining eight (29.6%) had normocytic anemia. Moreover, of the 92 GPCA + /DG + /EOLP patients, 24 had macrocytosis, and only 13 (54.2%) of these 24 patients had pernicious anemia., Conclusion: We conclude that GPCA + /DG + /EOLP patients may have vitamin B12 deficiency, iron deficiency, and an abnormally high blood homocysteine level. In addition to pernicious anemia, GPCA + /DG + /EOLP patients may sometimes have normocytic anemia or iron deficiency anemia., (Copyright © 2016. Published by Elsevier B.V.)

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. 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. 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. 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. [ABSTRACT FROM AUTHOR]

/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. 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. 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. 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. [ABSTRACT FROM AUTHOR]

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. 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. 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. 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. [ABSTRACT FROM AUTHOR]

Normocytosis is defined as having the mean corpuscular volume (MCV) between 80 fL and 99.9 fL. This study evaluated whether 770 burning mouth syndrome (BMS) patients with normocytosis (so-called normocytosis/BMS patients) had significantly higher frequencies of anemia, hematinic deficiencies, hyperhomocysteinemia, and serum gastric parietal cell antibody (GPCA) positivity than 442 healthy control subjects or 884 BMS patients. Complete blood count, serum iron, vitamin B12, folic acid, homocysteine, and GPCA levels in 884 BMS patients (including 770 normocytosis/BMS patients) and 442 healthy control subjects were measured and compared. We found that 12.3%, 13.2%, 2.2%, 2.3%, 17.3%, and 10.5% of 770 normocytosis/BMS patients had blood hemoglobin (Hb), iron, vitamin B12, and folic acid deficiencies, hyperhomocysteinemia, and serum GPCA positivity, respectively. Furthermore, 770 normocytosis/BMS patients had significantly higher frequencies of blood Hb, iron, vitamin B12, and folic acid deficiencies, hyperhomocysteinemia, and serum GPCA positivity than 442 healthy control subjects (all P -values < 0.005). On the contrary, 770 normocytosis/BMS patients had significantly lower frequencies of blood Hb and vitamin B12 deficiencies than overall 884 BMS patients (both P -values < 0.01). We conclude that there are significantly higher frequencies of anemia, serum iron, vitamin B12, and folic acid deficiencies, hyperhomocysteinemia, and serum GPCA positivity in normocytosis/BMS patients than in healthy control subjects. On the contrary, normocytosis/BMS patients do have significantly lower frequencies of blood Hb and vitamin B12 deficiencies than overall BMS patients. [ABSTRACT FROM AUTHOR]

Our previous study found that 222 of 884 burning mouth syndrome (BMS) patients have thyroglobulin antibody (TGA) positivity and/or thyroid microsomal antibody (TMA) positivity but without gastric parietal cell antibody positivity (GPCAˉTGA+/TMA+BMS patients). This study mainly assessed whether the serum TGA/TMA positivity was significantly associated with anemia, hematinic deficiencies, and hyperhomocysteinemia in GPCAˉTGA+/TMA+BMS patients. The complete blood count, iron, vitamin B12, folic acid, and homocysteine levels were measured and compared between 222 GPCAˉTGA+/TMA+BMS patients and 553 GPCA-negative, TGA-negative, and TMA-negative BMS patients (GPCAˉTGAˉTMAˉBMS patients) or 442 healthy control subjects. We found that 222 GPCAˉTGA+/TMA+BMS patients had significantly lower mean corpuscular volume (MCV) and lower blood Hb and serum iron levels than 442 healthy control subjects and significantly lower MCV and lower serum homocysteine levels than 553 GPCAˉTGAˉTMAˉBMS patients. Moreover, 222 GPCAˉTGA+/TMA+BMS patients had significantly greater frequencies of microcytosis, macrocytosis, blood Hb and serum iron deficiencies, and hyperhomocysteinemia than 442 healthy control subjects and significantly higher frequency of microcytosis but significantly lower frequency of hyperhomocysteinemia than 553 GPCAˉTGAˉTMAˉBMS patients. However, no significant differences in the frequencies of macrocytosis, blood Hb, serum iron, vitamin B12, and folic acid deficiencies were discovered between 222 GPCAˉTGA+/TMA+BMS patients and 553 GPCAˉTGAˉTMAˉBMS patients. We conclude that the disease of BMS itself does play a significant role in causing macrocytosis, anemia, hematinic deficiencies, and hyperhomocysteinemia in GPCAˉTGA+/TMA+BMS patients. However, the serum TGA/TMA-positivity is not significantly associated with anemia and serum iron, vitamin B12, and folic acid deficiencies in GPCAˉTGA+/TMA+BMS patients. [ABSTRACT FROM AUTHOR]

Background/purpose: Our previous study found significantly lower serum hematinic levels and higher serum homocysteine level as well as higher frequencies of serum hematinic deficiencies and hyperhomocysteinemia in oral leukoplakia (OL) patients than in healthy control subjects. This study evaluated whether carcinoembryonic antigen (CEA)-positive or squamous cell carcinoma-antigen (SCC-Ag)-positive OL patients had significantly lower serum hematinic levels and higher serum homocysteine level as well as significantly higher frequencies of hematinic deficiencies and hyperhomocysteinemia than CEA-negative or SCC-Ag-negative OL patients or healthy control subjects.Methods: The complete blood count, serum iron, vitamin B12, folic acid, and homocysteine levels in 184 OL patients including 85 CEA-positive, 99 CEA-negative, 25 SCC-Ag-positive, and 159 SCC-Ag-negative OL patients and in 184 age- and sex-matched healthy control subjects were measured and compared.Results: We found that the 85 CEA-positive or 25 SCC-Ag-positive OL patients had a significantly lower mean serum folic acid level and a significantly higher mean serum homocysteine level as well as significantly higher frequencies of serum folic acid deficiency and hyperhomocysteinemia than 184 healthy control subjects. Moreover, the 25 SCC-Ag-positive OL patients had a significantly higher mean serum homocysteine level than the 159 SCC-Ag-negative OL patients. The 85 CEA-positive OL patients had a higher mean serum homocysteine level and a higher frequency of hyperhomocysteinemia than 99 CEA-negative OL patients (marginally significant, P = 0.060).Conclusion: CEA-positive or SCC-Ag-positive OL patients tend to have a higher mean serum homocysteine level and a higher frequency of hyperhomocysteinemia than CEA-negative or SCC-Ag-negative OL patients, respectively. [ABSTRACT FROM AUTHOR]

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. 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. 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). 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. [ABSTRACT FROM AUTHOR]

Macrocytosis is defined as having the mean corpuscular volume (MCV) ≥ 100 fL. This study evaluated whether 46 burning mouth syndrome (BMS) patients with macrocytosis had significantly higher frequencies of anemia, hematinic deficiencies, hyperhomocysteinemia, and serum gastric parietal cell antibody (GPCA) positivity than 442 healthy control subjects or 884 BMS patients. Complete blood count, serum iron, vitamin B12, folic acid, homocysteine, and GPCA levels in 46 BMS patients with macrocytosis, 884 BMS patients, and 442 healthy control subjects were measured and compared. We found that 65.2%, 23.9%, 47.8%, 0.0%, 60.9%, and 45.7% of 46 BMS patients with macrocytosis were diagnosed as having blood hemoglobin, iron, vitamin B12, and folic acid deficiencies, hyperhomocysteinemia, and serum GPCA positivity, respectively. Moreover, 46 BMS patients with macrocytosis had significantly higher frequencies of blood hemoglobin and serum vitamin B12 deficiencies, hyperhomocysteinemia, and serum GPCA positivity than 442 healthy control subjects or 884 BMS patients (all P -values < 0.001). In addition, 46 BMS patients with macrocytosis also had a significantly higher frequency of serum iron deficiency than 442 healthy control subjects (P < 0.001). Pernicious anemia was found in 15 BMS patients with macrocytosis. There are significantly higher frequencies of anemia and serum iron and vitamin B12 deficiencies, hyperhomocysteinemia, and serum GPCA positivity in BMS patients with macrocytosis than in healthy control subjects. BMS patients with macrocytosis also have significantly higher frequencies of anemia, serum vitamin B12 deficiency, hyperhomocysteinemia, and serum GPCA positivity than BMS patients. [ABSTRACT FROM AUTHOR]

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. 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. 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. 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. [ABSTRACT FROM AUTHOR]

Background/purpose: Normocytosis is defined as having the mean corpuscular volume (MCV) between 80 fL and 99.9 fL. This study evaluated whether 944 atrophic glossitis (AG) patients with normocytosis had significantly higher frequencies of anemia, hematinic deficiencies, hyperhomocysteinemia, and serum gastric parietal cell antibody (GPCA) positivity than 532 healthy control subjects or 1064 AG patients.Methods: Complete blood count, serum iron, vitamin B12, folic acid, homocysteine, and GPCA levels in 944 AG patients with normocytosis, 1064 AG patients, and 532 healthy control subjects were measured and compared.Results: We found that 12.4%, 14.5%, 2.3%, 2.0%, 9.0%, and 25.7% of 944 AG patients with normocytosis had blood hemoglobin (Hb), iron, vitamin B12, and folic acid deficiencies, hyperhomocysteinemia, and serum GPCA positivity, respectively. Furthermore, 944 AG patients with normocytosis had significantly higher frequencies of blood Hb, iron, vitamin B12, folic acid deficiencies, hyperhomocysteinemia, and serum GPCA positivity than 532 healthy control subjects (all P-values < 0.01). On the contrary, 944 AG patients with normocytosis had significantly lower frequencies of blood Hb and vitamin B12 deficiencies and hyperhomocysteinemia than overall 1064 AG patients (all P-values < 0.05).Conclusion: We conclude that there are significantly higher frequencies of anemia and serum iron, vitamin B12, and folic acid deficiencies, hyperhomocysteinemia, and serum GPCA positivity in AG patients with normocytosis than in healthy control subjects. On the contrary, AG patients with normocytosis have significantly lower frequencies of blood Hb and vitamin B12 deficiencies and hyperhomocysteinemia than overall AG patients. [ABSTRACT FROM AUTHOR]

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). 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. 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. 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. [ABSTRACT FROM AUTHOR]

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. 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. 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. 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. [ABSTRACT FROM AUTHOR]

Background/purpose: Our previous study found that 180 of 1064 atrophic glossitis (AG) patients have iron deficiency. This study assessed whether all AG patients with iron deficiency (so-called ID/AG patients) had iron deficiency anemia (IDA) and evaluated whether the ID/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 180 ID/AG patients and 532 healthy control subjects were measured and compared.Results: We found that 180 ID/AG patients had significantly lower mean corpuscular volume (MCV) and lower mean blood Hb and serum iron levels as well as significantly higher mean serum homocysteine level than healthy control subjects (all P-values < 0.001). Moreover, 180 ID/AG patients had significantly higher frequencies of blood Hb (46.1%), serum iron (100.0%), vitamin B12 (8.3%), and folic acid (4.4%) deficiencies, hyperhomocysteinemia (16.1%), and serum GPCA positivity (31.1%) than 532 healthy control subjects (all P-values < 0.001). In addition, of 83 anemic ID/AG patients, 9 (10.8%) had pernicious anemia, 40 (48.2%) had normocytic anemia, 30 (36.2%) had IDA, and 4 (4.8%) had thalassemia trait-induced anemia.Conclusion: We conclude that ID/AG patients had significantly higher frequencies of blood Hb, serum iron, vitamin B12, and folic acid deficiencies, hyperhomocysteinemia, and serum GPCA positivity than 532 healthy control subjects. Normocytic anemia is the most common type of anemia in ID/AG patients, followed by IDA, pernicious anemia, and thalassemia trait-induced anemia. [ABSTRACT FROM AUTHOR]

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. 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. 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. 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. [ABSTRACT FROM AUTHOR]

Background/purpose: Macrocytosis is defined as having the mean corpuscular volume (MCV) ≧ 100 fL. This study evaluated whether 41 atrophic glossitis (AG) patients with macrocytosis had significantly higher frequencies of anemia, hematinic deficiencies, hyperhomocysteinemia, and serum gastric parietal cell antibody (GPCA) positivity than 532 healthy control subjects or 1064 AG patients.Methods: Complete blood count, serum iron, vitamin B12, folic acid, homocysteine, and GPCA levels in 41 AG patients with macrocytosis, 1064 AG patients, and 532 healthy control subjects were measured and compared.Results: We found that 73.2%, 22.0%, 73.2%, 4.9%, 80.5%, and 56.1% of 41 AG patients with macrocytosis were diagnosed as having blood hemoglobin, iron, vitamin B12, and folic acid deficiencies, hyperhomocysteinemia, and serum GPCA positivity, respectively. Moreover, 41 AG patients with macrocytosis had significantly higher frequencies of blood hemoglobin and serum vitamin B12 deficiencies, hyperhomocysteinemia, and serum GPCA positivity than 532 healthy control subjects or 1064 AG patients (all P-values < 0.001). In addition, 41 AG patients with macrocytosis also had significantly higher frequencies of serum iron and folic acid deficiencies than 532 healthy control subjects (both P-values < 0.001). Pernicious anemia was found in 22 AG patients with macrocytosis.Conclusion: There are significantly higher frequencies of anemia and serum iron, vitamin B12, and folic acid deficiencies, hyperhomocysteinemia, and serum GPCA positivity in AG patients with macrocytosis than in healthy control subjects. AG patients with macrocytosis also have significantly higher frequencies of blood hemoglobin and serum vitamin B12 deficiencies, hyperhomocysteinemia, and serum GPCA positivity than AG patients. [ABSTRACT FROM AUTHOR]

Background/purpose: 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.Methods: 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.Results: 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).Conclusion: 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. [ABSTRACT FROM AUTHOR]

Background/purpose: Our previous study found that 9 of 63 recurrent aphthous stomatitis (RAS)/Behcet's disease (BD) patients have serum gastric parietal cell antibody (GPCA) positivity. This study assessed whether serum GPCA positivity or RAS/BD itself was a significant factor causing hematinic deficiencies and hyperhomocysteinemia in GPCA-positive RAS/BD (GPCA+RAS/BD) or gastric and thyroid autoantibodies-negative RAS/BD (Abs-RAS/BD) patients.Methods: The mean blood hemoglobin (Hb), iron, vitamin B12, folic acid, and homocysteine levels were measured and compared between any two of three groups of 9 GPCA+RAS/BD patients, 41 Abs-RAS/BD patients, and 126 healthy control subjects.Results: GPCA+RAS/BD patients had significantly lower mean blood Hb (for men only), iron (for men only), and vitamin B12 levels as well as a significantly higher mean serum homocysteine level than 126 healthy control subjects. Moreover, GPCA+RAS/BD patients had significantly greater frequencies of blood Hb, iron, and vitamin B12 deficiencies and of hyperhomocysteinemia than healthy control subjects. GPCA+RAS/BD patients did have a significantly lower mean serum vitamin B12 level and a significantly higher mean serum homocysteine level as well as significantly greater frequencies of vitamin B12 deficiency and of hyperhomocysteinemia than Abs-RAS/BD patients. Moreover, Abs-RAS/BD patients did have significantly lower mean blood Hb, iron, and folic acid levels and significantly greater frequencies of blood Hb and iron deficiencies than healthy control subjects.Conclusion: The GPCA is a major factor causing vitamin B12 deficiency and hyperhomocyteinemia in GPCA+RAS/BD patients. RAS/BD itself does play a significant role in causing anemia and hematinic deficiencies in both GPCA+RAS/BD and Abs-RAS/BD patients. [ABSTRACT FROM AUTHOR]

Background/purpose: Approximately 27% of erosive oral lichen planus (EOLP) patients have serum anti-gastric parietal cell antibody (GPCA) positivity. This study assessed whether serum GPCA or EOLP itself was a significant factor that caused hematinic deficiencies and anemia statuses in GPCA-positive or autoantibodies-negative EOLP patients (GPCA+/EOLP and Abs-/EOLP patients).Methods: The mean corpuscular volume (MCV) and mean blood hemoglobin (Hb), iron, vitamin B12, and folic acid levels were measured and compared between any two of three groups of 41 GPCA+/EOLP patients, 198 Abs-/EOLP patients, and 184 healthy control subjects.Results: GPCA+/EOLP patients had significantly lower mean Hb, iron (for women only), and vitamin B12 level as well as significantly greater frequencies of Hb, iron, and vitamin B12 deficiencies than healthy control subjects. Moreover, GPCA+/EOLP patients had significantly lower serum vitamin B12 level and significantly higher MCV as well as a significantly greater frequency of vitamin B12 deficiency than Abs-/EOLP patients. Furthermore, Abs-/EOLP patients did have significantly lower mean Hb, MCV, iron (for women only), vitamin B12, and folic acid levels as well as significantly greater frequencies of Hb and iron deficiencies than healthy control subjects.Conclusion: We conclude that serum GPCA is the major factor that causes vitamin B12 deficiency, macrocytosis and pernicious anemia in GPCA+/EOLP patients. Approximately 29-32% GPCA-positive EOLP patients have vitamin B12 deficiency or macrocytosis and about 23-25% vitamin B12 deficiency or macrocytosis EOLP patients have pernicious anemia. ELOP itself does play a significant role in causing anemia and hematinic deficiencies in Abs-/EOLP patients. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Background/purpose: Serum anti-gastric parietal cell (GPCA), anti-thyroglobulin (TGA), and anti-thyroid microsomal antibodies (TMA) can be found in some recurrent aphthous stomatitis (RAS) patients. This study mainly assessed whether serum GPCA, TGA, TMA and RAS itself played significant roles in causing anemia and hematinic deficiencies in TGA/TMA-positive RAS patients with GPCA positivity (GPCA+/TGA/TMA/RAS patients) or negativity (GPCA-/TGA/TMA/RAS patients).Methods: The mean corpuscular volume (MCV) and mean blood hemoglobin (Hb), iron, vitamin B12, and folic acid levels were measured and compared between any two of the four groups of 15 GPCA+/TGA/TMA/RAS patients, 69 GPCA-/TGA/TMA/RAS patients, 240 all autoantibodies-negative RAS patients (Abs-/RAS patients), and 342 healthy control subjects.Results: GPCA+/TGA/TMA/RAS patients had significantly lower mean Hb (for men only) and vitamin B12 levels as well as significantly greater frequencies of Hb, iron, and vitamin B12 deficiencies than healthy control subjects. GPCA+/TGA/TMA/RAS patients had lower serum vitamin B12 level and higher MCV as well as a significantly greater frequency of vitamin B12 deficiency than GPCA-/TGA/TMA/RAS patients. Furthermore, both GPCA-/TGA/TMA/RAS and Abs-/RAS patients did have significantly lower mean Hb, MCV, and iron levels as well as significantly greater frequencies of Hb, iron and vitamin B12 deficiencies than healthy control subjects. There were no significant differences in blood data between GPCA-/TGA/TMA/RAS and Abs-/RAS patients CONCLUSION: Both serum GPCA positivity and RAS itself are the contributing factors causing anemia and hematinic deficiencies in GPCA+/TGA/TMA/RAS patients. RAS itself but not TGA/TMA positivity plays a significant role in causing anemia and hematinic deficiencies in GPCA-/TGA/TMA/RAS patients. [ABSTRACT FROM AUTHOR]

Background/purpose: Some of recurrent aphthous stomatitis (RAS) patients had concomitant atrophic glossitis (AG). This study assessed whether RAS patients with AG (AG+/RAS patients) or without AG (AG-/RAS patients) had anemia and hematinic deficiencies and to evaluate whether RAS combined with AG or RAS itself was a significant factor causing anemia and hematinic deficiencies in AG+/RAS or AG-/RAS patients, respectively.Methods: The mean corpuscular volume (MCV) and mean blood hemoglobin (Hb), iron, vitamin B12, and folic acid levels were measured and compared between any two of three groups of 160 AG+/RAS patients, 195 AG-/RAS patients, and 355 healthy control subjects.Results: Both AG+/RAS and AG-/RAS patients had significantly lower mean Hb, iron, and vitamin B12 levels as well as significantly greater frequencies of Hb, iron, vitamin B12, and folic acid deficiencies than healthy control subjects. Moreover, AG+/RAS patients had significantly lower mean Hb and serum iron level (for women only) and significantly greater frequencies of Hb and iron deficiencies than AG-/RAS patients. Of 69 anemia AG+/RAS patients, 30 (43.5%) had normocytic anemia and 23 (33.3%) had iron deficiency anemia. Of 38 anemia AG-/RAS patients, 26 (68.4%) had normocytic anemia and 5 (13.2%) had iron deficiency anemia.Conclusion: We conclude that some of AG+/RAS or AG-/RAS patients do have anemia and hematinic deficiencies and AG+/RAS patients do have severer anemia statuses and iron deficiency than AG-/RAS patients. RAS combined with AG or RAS itself does play a significant role in causing anemia and hematinic deficiencies in AG+/RAS or AG-/RAS patients, respectively. [ABSTRACT FROM AUTHOR]