Significantly higher frequencies of anemia, vitamin B12 deficiency, and hyperhomocysteinemia in recurrent aphthous stomatitis patients with macrocytosis

Authors

• Yu-Hsueh Wu, Department of Stomatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
• 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
• 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: Macrocytosis is defined as having the mean corpuscular volume (MCV) ≥ 100 fL. This study evaluated whether 14 recurrent aphthous stomatitis (RAS) patients with macrocytosis (macrocytosis/RAS patients) had significantly higher frequencies of anemia, hematinic deficiencies, hyperhomocysteinemia, and serum gastric parietal cell antibody (GPCA) positivity than 430 healthy control subjects or 430 RAS patients.

Materials and methods: Complete blood count, serum iron, vitamin B12, folic acid, homocysteine, and GPCA levels in 14 macrocytosis/RAS patients, 430 RAS patients, and 430 healthy control subjects were measured and compared.

Results: We found that 92.9%, 14.3%, 85.7%, 0.0%, 85.7%, and 35.7% of 14 macrocytosis/RAS patients were diagnosed as having anemia, serum iron, vitamin B12, and folic acid deficiencies, hyperhomocysteinemia, and serum GPCA positivity, respectively. Moreover, 14 macrocytosis/RAS patients had significantly higher frequencies of anemia, serum vitamin B12 deficiency, hyperhomocysteinemia, and serum GPCA positivity than 430 healthy control subjects or 430 RAS patients (all P-values < 0.05). In addition, 14 macrocytosis/RAS patients also had a significantly higher frequency of serum iron deficiency than 430 healthy control subjects (P < 0.001). Pernicious anemia was found in 4 of 14 macrocytosis/RAS patients.

Conclusion: There are significantly higher frequencies of anemia, serum iron and vitamin B12 deficiencies, hyperhomocysteinemia, and serum GPCA positivity in 14 macrocytosis/RAS patients than in 430 healthy control subjects. Moreover, 14 macrocytosis/RAS patients also have significantly higher frequencies of anemia, serum vitamin B12 deficiency, hyperhomocysteinemia, and serum GPCA positivity than 430 RAS patients.

Recommended Citation

Wu, Yu-Hsueh; Wang, Yi-Ping; Lee, Yi-Pang; Chang, Julia Yu-Fong; Sun, Andy; and Chiang, Chun-Pin (2026) "Significantly higher frequencies of anemia, vitamin B12 deficiency, and hyperhomocysteinemia in recurrent aphthous stomatitis patients with macrocytosis," Journal of Dental Sciences: Vol. 21: Iss. 4, Article 45.
Available at: https://jds.ads.org.tw/journal/vol21/iss4/45

Publication Date

2026

Received Date

August 10 2026

Accepted Date

August 12 2026