Anemia, hematinic deficiencies, and gastric parietal cell antibody positivity in burning mouth syndrome patients with or without hyperhomocysteinemia

Meng-Ling Chiang; Chun-Pin Chiang; Andy Sun

doi:10.1016/j.jds.2020.04.013

Anemia, hematinic deficiencies, and gastric parietal cell antibody positivity in burning mouth syndrome patients with or without hyperhomocysteinemia

J Dent Sci. 2020 Jun;15(2):214-221. doi: 10.1016/j.jds.2020.04.013. Epub 2020 May 15.

Authors

Meng-Ling Chiang^{1

2

3}, Chun-Pin Chiang^{4

5

6

7}, Andy Sun^{5

6}

Affiliations

¹ Department of Pediatric Dentistry, Chang Gung Memorial Hospital, Taipei, Taiwan.
² Department of Oral Pathology and Oral Diagnosis, Chang Gung Memorial Hospital, Taipei, Taiwan.
³ College of Medicine, Chang Gung University, Taoyuan, Taiwan.
⁴ Department of Dentistry, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.
⁵ Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan.
⁶ Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.
⁷ Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan.

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.

Keywords: Burning mouth syndrome; Hyperhomocysteinemia; Normocytic anemia; Pernicious anemia; Vitamin B12 deficiency.