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Esquivel-Pedraza L, Cicero-Casarrubias A, Fernández-Cuevas L, Chávez-Ramírez M, Milke-García MP, Domínguez-Cherit J, Méndez-Flores S, Guerrero-Manzo VL. Clinical atrophy patterns of filiform papillae of the tongue and their relationship with the serum levels of iron, vitamin B12 and folic acid in patients with systemic diseases. Int J Dermatol 2023. [PMID: 37038250 DOI: 10.1111/ijd.16669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 01/28/2023] [Accepted: 03/14/2023] [Indexed: 04/12/2023]
Abstract
BACKGROUND The purpose of the study was to evaluate the clinical patterns of atrophy of the filiform papillae (FP) of the tongue and their relationship with the serum levels of iron and vitamin B12 among patients with systemic diseases, in a tertiary care center. METHODS A cross-sectional, analytical, research study was designed. A systematic tongue examination was performed to evaluate the presence and clinical patterns of FP atrophy. We collected epidemiologic, clinical, and laboratory data. Statistical analysis included χ2 test, Fisher's exact test, Kruskal-Wallis test, and a logistic regression analysis. RESULTS A total of 87 patients (83.9% females) were included [median age = 55 (range 20-89) years]. Endocrinopathy (60.9%) was the most frequent comorbidity. We found atrophy of the FP in 90.8% of the patients; the atrophy was mild in 83.5% of the cases, and severe in 16.5%. The most common atrophic patterns were as follows: focalized in 64 (73.6%) cases, "U"-shaped pattern in 60 (69%), and generalized in 30 (34.5%). Geographic tongue and median rhomboid glossitis were observed in 12 (13.8%) and 11 (12.6%) subjects, respectively. Lower titers of serum iron were detected in cases with focal (median = 71 vs. 110 mcg/dl) and generalized (median = 55 vs. 78 mcg/dl) FP atrophy (P = 0.03 and P = 0.009, respectively), than their counterparts. The presence of symptomatology was related to the focal pattern of atrophy (P = 0.038). CONCLUSIONS A high frequency of filiform papillary atrophy of the tongue was observed in patients with comorbidities. Some atrophic patterns of the tongue were significantly associated with certain medical conditions.
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Affiliation(s)
- Lilly Esquivel-Pedraza
- Dermatology Department, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico City, Mexico
- Research & Educational Doctoral Program, Universidad Centro Panamericano de Estudios Superiores, Zitácuaro, Michoacán, Mexico
| | - Alba Cicero-Casarrubias
- Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico City, Mexico
| | - Laura Fernández-Cuevas
- Oral Pathology Department, Centro Dermatológico "Dr. Ladislao de la Pascua", Mexico City, Mexico
| | - Margarita Chávez-Ramírez
- Nutrition Division, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico City, Mexico
| | - María P Milke-García
- Nutrition Division, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico City, Mexico
| | - Judith Domínguez-Cherit
- Dermatology Department, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico City, Mexico
| | - Silvia Méndez-Flores
- Dermatology Department, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico City, Mexico
| | - Víctor L Guerrero-Manzo
- Research & Educational Doctoral Program, Universidad Centro Panamericano de Estudios Superiores, Zitácuaro, Michoacán, Mexico
- Centro de Actualización del Magisterio en Michoacán, Morelia, Michoacán, Mexico
- Hospital Regional ISSSTE, Morelia, Michoacán, Mexico
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Wu YH, Wu YC, Yu-Fong Chang J, Lee YP, Chiang CP, Sun A. Significantly lower mean serum vitamin B12 and folic acid levels and a significantly higher frequency of serum iron deficiency in younger than in older atrophic glossitis patients. J Dent Sci 2022; 17:1487-1493. [PMID: 36299347 PMCID: PMC9588847 DOI: 10.1016/j.jds.2022.05.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Indexed: 12/31/2022] Open
Abstract
Background/purpose : Our previous study found that 19.0%, 16.9%, 5.3%, 2.3%, and 11.9% of 1064 atrophic glossitis (AG) patients have anemia, serum iron, vitamin B12, and folic acid deficiencies, and hyperhomocysteinemia, respectively. This study mainly evaluated the anemia, hematinic deficiencies, and hyperhomocysteinemia in 224 younger (≤50 years old) and 840 older (>50 years old) AG patients. Materials and methods The blood hemoglobin (Hb) and serum iron, vitamin B12, folic acid, and homocysteine levels in 224 younger and 840 older AG patients were measured and compared with the corresponding levels in 112 younger (≤50 years old) and 420 older (>50 years old) healthy control subjects (HCSs), respectively. Results We found that 224 younger AG patients had significantly lower mean blood Hb and serum iron levels than 112 younger HCSs. Moreover, 840 older AG patients had significantly lower mean blood Hb and serum iron levels and a significantly higher mean serum homocysteine level than 420 older HCSs. In addition, 224 younger AG patients had significantly lower mean serum vitamin B12 and folic acid levels, a lower mean serum homocysteine level (marginal significance, P = 0.056), a significantly higher frequency of serum iron deficiency, and a significantly lower frequency of hyperhomocysteinemia than 840 older AG patients. Conclusion The younger AG patients do have significantly lower mean serum vitamin B12 and folic acid levels, a significantly higher frequency of serum iron deficiency, and a significantly lower frequency of hyperhomocysteinemia than the older AG patients.
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Affiliation(s)
- Yu-Hsueh Wu
- Department of Stomatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Institute of Oral Medicine, School of Dentistry, National Cheng Kung University, Tainan, Taiwan
| | - Yang-Che Wu
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Dentistry, Taipei Medical University-Shuang Ho Hospital, Ministry of Health and Welfare, New Taipei City, Taiwan
| | - Julia Yu-Fong Chang
- Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
- Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan
| | - Yi-Pang Lee
- Department of Dentistry, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Chun-Pin Chiang
- Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
- Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan
- Department of Dentistry, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
- Corresponding author. Department of Dentistry, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No. 707, Section 3, Chung-Yang Road, Hualien 970, Taiwan.
| | - Andy Sun
- Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
- Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan
- Corresponding author. Department of Dentistry, National Taiwan University Hospital, No. 1, Chang-Te Street, Taipei 10048, Taiwan.
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Wu YH, Wu YC, Chang JYF, Lee YP, Chiang CP, Sun A. Significantly higher frequencies of macrocytosis, anemia, serum vitamin B12 and folic acid deficiencies, and hyperhomocysteinemia in male than in female atrophic glossitis patients. J Dent Sci 2022; 17:1371-1377. [PMID: 35784143 PMCID: PMC9236945 DOI: 10.1016/j.jds.2022.05.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 05/16/2022] [Indexed: 12/31/2022] Open
Abstract
Background/purpose Our previous study found that 19.0%, 16.9%, 5.3%, 2.3%, 11.9%, and 26.7% of 1064 atrophic glossitis (AG) patients have anemia, serum iron, vitamin B12, and folic acid deficiencies, hyperhomocysteinemia, and serum gastric parietal cell antibody (GPCA) positivity, respectively. This study evaluated the anemia, hematinic deficiencies, and hyperhomocysteinemia in 150 male and 914 female AG patients. Materials and methods The blood hemoglobin (Hb) and serum iron, vitamin B12, folic acid, homocysteine, GPCA levels in 150 male and 914 female AG patients were measured and compared with the corresponding levels in 75 male and 457 female healthy control subjects (HCSs), respectively. Results We found that 150 male AG patients had significantly lower mean blood Hb, serum iron, vitamin B12, and folic acid levels, and significantly higher mean serum homocysteine levels than 75 male HCSs. Moreover, 914 female AG patients had significantly lower mean blood Hb and serum iron levels and significantly higher mean serum homocysteine level than 457 female HCSs. In addition, 150 male AG patients had significantly higher mean blood Hb and serum homocysteine levels, significantly lower mean serum vitamin B12 and folic acid levels, and significantly higher frequencies of Hb, vitamin B12, and folic acid deficiency and hyperhomocysteinemia than 914 female AG patients. Conclusion The male AG patients do have significantly higher mean blood Hb and serum homocysteine levels, significantly lower mean serum vitamin B12 and folic acid levels, and significantly higher frequencies of Hb, vitamin B12, and folic acid deficiencies and hyperhomocysteinemia than the female AG patients.
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Jin YT, Wu YC, Wu YH, Chang JYF, Chiang CP, Sun A. Anemia, hematinic deficiencies, hyperhomocysteinemia, and gastric parietal cell antibody positivity in burning mouth syndrome patients with or without microcytosis. J Dent Sci 2021; 16:608-613. [PMID: 33854709 PMCID: PMC8025219 DOI: 10.1016/j.jds.2020.12.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND/PURPOSE Microcytosis is defined as having mean corpuscular volume <80 fL. This study evaluated whether 68 burning mouth syndrome (BMS) patients with microcytosis and 816 BMS patients without microcytosis had higher frequencies of anemia, hematinic deficiencies, hyperhomocysteinemia, and serum gastric parietal cell antibody (GPCA) positivity than 442 healthy control subjects. MATERIALS AND METHODS Complete blood count and serum iron, vitamin B12, folic acid, homocysteine, and GPCA levels in 68 BMS patients with microcytosis, 816 BMS patients without microcytosis, and 442 healthy control subjects were measured and compared. RESULTS We found that 73.5%, 44.1%, 4.4%, 2.9%, 13.2%, and 10.3% of 68 BMS patients with microcytosis and 15.3%, 13.8%, 4.8%, 2.2%, 19.7%, and 12.5% of 816 BMS patients without microcytosis had blood hemoglobin, iron, vitamin B12, and folic acid deficiencies, hyperhomocysteinemia, and serum GPCA positivity, respectively. Both 68 BMS patients with microcytosis and 816 BMS patients without microcytosis had significantly higher frequencies of blood hemoglobin, iron, vitamin B12, and folic acid deficiencies, hyperhomocysteinemia, and serum GPCA positivity than 442 healthy control subjects (all P-values < 0.05). Moreover, 68 BMS patients with microcytosis had significantly higher frequencies of blood hemoglobin and iron deficiencies than 816 BMS patients without microcytosis. CONCLUSION There are significantly higher frequencies of anemia, serum iron, vitamin B12, and folic acid deficiencies, hyperhomocysteinemia, and serum GPCA positivity in BMS patients with or without microcytosis than in healthy control subjects. BMS patients with microcytosis have significantly higher frequencies of blood hemoglobin and iron deficiencies than BMS patients without microcytosis.
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Affiliation(s)
- Ying-Tai Jin
- Department of Pathology, Taiwan Adventist Hospital, Taipei, Taiwan
- Department of Pathology, National Cheng-Kung University Hospital, Tainan, Taiwan
| | - Yang-Che Wu
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Dentistry, Taipei Medical University-Shuang Ho Hospital, Ministry of Health and Welfare, New Taipei City, Taiwan
| | - Yu-Hsueh Wu
- Department of Stomatology, National Cheng Kung University Hospital, Tainan, Taiwan
- Institute of Oral Medicine, School of Dentistry, National Cheng Kung University, Tainan, Taiwan
| | - Julia Yu-Fong Chang
- Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
- Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan
| | - Chun-Pin Chiang
- Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
- Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan
- Department of Dentistry, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Andy Sun
- Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
- Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan
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Which one, gastric parietal cell antibody positivity or hyperhomocysteinemia, is a better biomarker to predict oral mucosal disease patients with vitamin B12 deficiency? J Formos Med Assoc 2020; 120:906-907. [PMID: 32855035 DOI: 10.1016/j.jfma.2020.08.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Accepted: 08/11/2020] [Indexed: 11/21/2022] Open
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Chiang ML, Chiang CP, Sun A. Anemia, hematinic deficiencies, and gastric parietal cell antibody positivity in burning mouth syndrome patients with or without hyperhomocysteinemia. J Dent Sci 2020; 15:214-221. [PMID: 32595904 PMCID: PMC7305457 DOI: 10.1016/j.jds.2020.04.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 04/29/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND/PURPOSE Our previous study found that 170 of 884 burning mouth syndrome (BMS) patients have hyperhomocysteinemia. This study assessed whether these 170 BMS patients with hyperhomocysteinemia had significantly higher frequencies of anemia, hematinic deficiencies, and serum gastric parietal cell antibody (GPCA) positivity than 714 BMS patients without hyperhomocysteinemia or 442 healthy control subjects. MATERIALS AND METHODS The blood hemoglobin (Hb) and serum iron, vitamin B12, folic acid, homocysteine, and GPCA levels in 170 BMS patients with hyperhomocysteinemia, 714 BMS patients without hyperhomocysteinemia, and 442 healthy control subjects were measured and compared. RESULTS We found that 170 BMS patients with hyperhomocysteinemia had significantly higher frequencies of macrocytosis, blood Hb and serum iron, vitamin B12, and folic acid deficiencies, and serum GPCA positivity than 442 healthy control subjects (all P-values < 0.001) or 714 BMS patients without hyperhomocysteinemia (all P-values < 0.05). Anemia was found in 77 of 170 BMS patients with hyperhomocysteinemia and in 98 of 714 BMS patients without hyperhomocysteinemia. Normocytic anemia (47 cases) and pernicious anemia (15 cases) were the two most common types of anemia in 170 BMS patients with hyperhomocysteinemia. Moreover, normocytic anemia (48 cases), iron deficiency anemia (21 cases), and thalassemia trait-induced anemia (21 cases) were the three most common types of anemia in 714 BMS patients without hyperhomocysteinemia. CONCLUSION BMS patients with hyperhomocysteinemia had significantly higher frequencies of macrocytosis, anemia, serum iron, vitamin B12, and folic acid deficiencies, and serum GPCA positivity than healthy control subjects or BMS patients without hyperhomocysteinemia.
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Affiliation(s)
- Meng-Ling Chiang
- Department of Pediatric Dentistry, Chang Gung Memorial Hospital, Taipei, Taiwan
- Department of Oral Pathology and Oral Diagnosis, Chang Gung Memorial Hospital, Taipei, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chun-Pin Chiang
- Department of Dentistry, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan
- Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
- Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan
| | - Andy Sun
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan
- Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
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Smart link of chronic atrophic gastritis with atrophic glossitis, gastric parietal cell antibody positivity, vitamin B12 deficiency, and hyperhomocysteinemia. J Formos Med Assoc 2020; 119:1006-1007. [PMID: 32024596 DOI: 10.1016/j.jfma.2020.01.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 01/13/2020] [Indexed: 12/15/2022] Open
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Pellicano R. Is chronic atrophic gastritis the missing link between atrophic glossitis, gastric parietal cell antibody positivity and hematological deficiencies? J Formos Med Assoc 2020; 119:1004-1005. [PMID: 31992475 DOI: 10.1016/j.jfma.2020.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 01/08/2020] [Indexed: 11/18/2022] Open
Affiliation(s)
- Rinaldo Pellicano
- Unit of Gastroenterology and Hepatology, Molinette-SGAS Hospital, Turin, Italy.
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