Hematinic deficiencies and anemia statuses in antigastric parietal cell antibody-positive erosive oral lichen planus patients with desquamative gingivitis

• Main Authors: Julia Yu-Fong Chang, Yi-Ping Wang, Yang-Che Wu, Yu-Hsueh Wu, Chih-Huang Tseng, Andy Sun
• Format: Article
• Language: English
• Published: Elsevier 2016-10-01
• Series: Journal of the Formosan Medical Association
• Subjects: antigastric parietal cell antibody; desquamative gingivitis; macrocytosis; oral lichen planus; pernicious anemia; vitamin B12 deficiency
• Online Access: http://www.sciencedirect.com/science/article/pii/S0929664616301486

Erosive oral lichen planus (EOLP) patients with desquamative gingivitis (DG) are sometimes encountered in our oral mucosal disease clinic. This study assessed hematinic deficiencies and anemia statuses in antigastric parietal cell antibody (GPCA)-positive EOLP patients with DG (GPCA+/DG+/EOLP patients). Methods: The blood hemoglobin, iron, vitamin B12, folic acid, and homocysteine concentrations and serum GPCA levels in 92 GPCA+/DG+/EOLP patients and 184 age- and sex-matched healthy controls were measured and compared between the two groups. Results: We found that 27 (29.3%), 16 (17.4%), and 27 (29.3%) of 92 GPCA+/DG+/EOLP patients had hemoglobin (men < 13 g/dL and women < 12 g/dL), iron (< 60 μg/dL), and vitamin B12 (< 200 pg/mL) deficiencies, respectively. Moreover, 37 (40.2%) of 92 GPCA+/DG+/EOLP patients had an abnormally high blood homocysteine level (> 12.1μM). GPCA+/DG+/EOLP patients had a significantly higher frequency of hemoglobin, iron, or vitamin B12 deficiency and an abnormally high blood homocysteine level than healthy control individuals (all p < 0.001). Of 27 anemic GPCA+/DG+/EOLP patients, 13 (48.2%) had pernicious anemia, five (18.5%) had iron deficiency anemia, one (3.7%) had thalassemia trait, and the remaining eight (29.6%) had normocytic anemia. Moreover, of the 92 GPCA+/DG+/EOLP patients, 24 had macrocytosis, and only 13 (54.2%) of these 24 patients had pernicious anemia. Conclusion: We conclude that GPCA+/DG+/EOLP patients may have vitamin B12 deficiency, iron deficiency, and an abnormally high blood homocysteine level. In addition to pernicious anemia, GPCA+/DG+/EOLP patients may sometimes have normocytic anemia or iron deficiency anemia.