Anemia, hematinic deficiencies, hyperhomocysteinemia, and serum gastric parietal cell antibody positivity in recurrent aphthous stomatitis patients with vitamin B12 deficiency

Authors

• Yi-Ping Wang, Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
• Yi-Pang Lee, Department of Dentistry, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
• Yu-Hsueh Wu, Department of Stomatology, National Cheng Kung University Hospital, College of Medicine, 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
• Andy Sun, Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
• Chun-Pin Chiang, Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, TaiwanFollow

Abstract

Background/purpose: Our previous study found that 30 of 430 recurrent aphthous stomatitis (RAS) patients have vitamin B12 deficiency. This study assessed whether the vitamin B12-deficient RAS (B12D/RAS) 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/RAS patients had pernicious anemia (PA).

Materials and methods: The blood hemoglobin (Hb) and serum iron, vitamin B12, folic acid, homocysteine, and GPCA levels in 430 RAS patients including 30 B12D/RAS patients and 430 healthy control subjects were measured and compared.

Results: We found that 30 B12D/RAS patients had significantly lower mean blood Hb, serum iron (for women only), and vitamin B12 levels as well as significantly higher mean corpuscular volume (MCV) and mean serum homocysteine level than 430 healthy control subjects (all P-values < 0.001). Moreover, 30 B12D/RAS patients had significantly higher frequencies of macrocytosis (40.0%), blood Hb (60.0%) and serum iron (20.0%) and vitamin B12 (100.0%) deficiencies, hyperhomocysteinemia (83.3%), and serum GPCA positivity (40.0%) than 430 healthy control subjects (all P-values < 0.001). The three most common types of anemia in 18 anemic B12D/RAS patients were macrocytic anemia other than PA (7 patients, 38.9%), PA (4 patients, 22.2%), and normocytic anemia (4 patients, 22.2%).

Conclusion: The B12D/RAS 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. Only 4 (13.3%) of 30 B12D/RAS patients have PA.

Recommended Citation

Wang, Yi-Ping; Lee, Yi-Pang; Wu, Yu-Hsueh; Chang, Julia Yu-Fong; Sun, Andy; and Chiang, Chun-Pin (2026) "Anemia, hematinic deficiencies, hyperhomocysteinemia, and serum gastric parietal cell antibody positivity in recurrent aphthous stomatitis patients with vitamin B12 deficiency," Journal of Dental Sciences: Vol. 21: Iss. 4, Article 16.
Available at: https://jds.ads.org.tw/journal/vol21/iss4/16

Publication Date

2026

Received Date

July 29 2026

Accepted Date

Aug 02 2026