Anemia, hematinic deficiencies, and hyperhomocysteinemia in gastric parietal cell antibody-positive and -negative burning mouth syndrome patients

Meng-Ling Chiang; Yu-Hsueh Wu; Julia Yu-Fong Chang; Yi-Ping Wang; Yang-Che Wu; Andy Sun

doi:10.1016/j.jfma.2020.08.032

Anemia, hematinic deficiencies, and hyperhomocysteinemia in gastric parietal cell antibody-positive and -negative burning mouth syndrome patients

J Formos Med Assoc. 2021 Feb;120(2):819-826. doi: 10.1016/j.jfma.2020.08.032. Epub 2020 Sep 2.

Authors

Meng-Ling Chiang¹, Yu-Hsueh Wu², Julia Yu-Fong Chang³, Yi-Ping Wang³, Yang-Che Wu⁴, Andy Sun⁵

Affiliations

¹ 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.
² Department of Dentistry, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Graduate Institute of Clinical Dentistry, School of Dentistry, 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; Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan.
⁴ 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.
⁵ 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: 32888843
DOI: 10.1016/j.jfma.2020.08.032

Abstract

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.

Keywords: Burning mouth syndrome; Gastric parietal cell antibody; Macrocytosis; Vitamin B12 deficiency; hyperhomocysteinemia.

MeSH terms

Anemia*
Burning Mouth Syndrome* / epidemiology
Folic Acid
Folic Acid Deficiency / complications
Folic Acid Deficiency / epidemiology
Glossitis
Hematinics*
Hemoglobins / analysis
Humans
Hyperhomocysteinemia* / complications
Hyperhomocysteinemia* / epidemiology
Iron
Parietal Cells, Gastric
Vitamin B 12
Vitamin B 12 Deficiency / complications
Vitamin B 12 Deficiency / epidemiology

Substances

Hematinics
Hemoglobins
Folic Acid
Iron
Vitamin B 12