Anemia and hematinic deficiencies in gastric parietal cell antibody-positive and antibody-negative erosive oral lichen planus patients with thyroid antibody positivity

Julia Y-F Chang; I-Chang Chen; Yi-Ping Wang; Yu-Hsueh Wu; Hsin-Ming Chen; Andy Sun

doi:10.1016/j.jfma.2016.09.007

Anemia and hematinic deficiencies in gastric parietal cell antibody-positive and antibody-negative erosive oral lichen planus patients with thyroid antibody positivity

J Formos Med Assoc. 2016 Nov;115(11):1004-1011. doi: 10.1016/j.jfma.2016.09.007. Epub 2016 Oct 29.

Authors

Julia Y-F Chang¹, I-Chang Chen², Yi-Ping Wang¹, Yu-Hsueh Wu², Hsin-Ming Chen¹, Andy Sun³

Affiliations

¹ 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.
² 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.
³ 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. Electronic address: andysun7702@yahoo.com.tw.

PMID: 27802920
DOI: 10.1016/j.jfma.2016.09.007

Abstract

Background/purpose: Serum gastric parietal cell antibody (GPCA), thyroglobulin antibody (TGA), and thyroid microsomal antibody (TMA) are found in some erosive oral lichen planus (EOLP) patients. This study assessed whether serum GPCA, TGA and TMA and EOLP itself played significant roles in causing anemia and hematinic deficiencies in TGA/TMA-positive EOLP patients with GPCA positivity (GPCA⁺/TGA/TMA/EOLP patients) or negativity (GPCA^-/TGA/TMA/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 the four groups of 29 GPCA⁺/TGA/TMA/EOLP patients, 80 GPCA^-/TGA/TMA/EOLP patients, 198 all antibodies-negative EOLP patients (Abs^-/EOLP patients), and 218 healthy control individuals.

Results: GPCA⁺/TGA/TMA/EOLP patients had significantly lower mean Hb and vitamin B12 levels as well as significantly greater frequencies of Hb, iron, and vitamin B12 deficiencies than healthy controls. GPCA⁺/TGA/TMA/EOLP patients had significantly lower serum vitamin B12 level and higher MCV as well as a significantly greater frequency of vitamin B12 deficiency than GPCA^-/TGA/TMA/EOLP patients. Furthermore, both GPCA^-/TGA/TMA/EOLP and Abs^-/EOLP patients did have significantly lower mean Hb, MCV, and iron (for women only) levels, as well as significantly greater frequencies of Hb and iron deficiencies than healthy controls. However, there were no significant differences in measured blood data between GPCA^-/TGA/TMA/EOLP and Abs^-/EOLP patients.

Conclusion: We conclude that serum GPCA is the major factor causing vitamin B12 deficiency, macrocytosis and pernicious anemia in GPCA⁺/TGA/TMA/EOLP patients. ELOP itself but not TGA/TMA positivity plays a significant role in causing anemia and hematinic deficiencies in GPCA^-/TGA/TMA/EOLP patients.

Keywords: gastric parietal cell antibody; macrocytosis; oral lichen planus; pernicious anemia; thyroid antibody; vitamin B12 deficiency.

MeSH terms

Adult
Aged
Aged, 80 and over
Anemia, Pernicious / blood*
Anemia, Pernicious / complications
Autoantibodies / blood*
Case-Control Studies
Erythrocyte Indices
Female
Folic Acid / blood
Hemoglobins / analysis
Humans
Iron / blood
Lichen Planus, Oral / blood*
Lichen Planus, Oral / complications
Lichen Planus, Oral / immunology
Male
Middle Aged
Parietal Cells, Gastric / immunology*
Taiwan
Vitamin B 12 / blood
Vitamin B 12 Deficiency / blood*
Vitamin B 12 Deficiency / complications

Substances

Autoantibodies
Hemoglobins
anti-thyroglobulin
thyroid microsomal antibodies
Folic Acid
Iron
Vitamin B 12