Haematological deficiencies in patients with recurrent aphthosis

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Abstract
Background  Recurrent aphthosis is a common oral ulcerative condition consisting also of a subset of similar ulcers, properly named ‘aphthous‐like’ ulcers (ALU), linked to systemic diseases and among these, to iron, folic acid and vitamin B12 deficiencies.Objectives  The main objectives of this study were: (i) to evaluate the association between recurrent aphthosis and the most common predisposing factors; (ii) to assess the frequency of ALU in recurrent aphthosis; (iii) to verify the efficacy of a replacement therapy in all ALU patients.Methods  Thirty‐two adults with recurrent aphthosis and 29 otherwise healthy controls were consecutively recruited, interviewed and subjected to haematological investigations.Results  Family history of recurrent aphthosis was significantly associated (P < 0.01). The overall frequency of haematinic deficiencies was 56.2% in recurrent aphthosis patients vs. 7% in controls (P < 0.0001). All ALU patients with a negative family history showed a complete remission of the ulcerative episodes after replacement therapy, while those with a positive family history only had a reduction in frequency and severity. In the logistic regression model, only family history was associated with recurrent aphthosis (P = 0.0137).Conclusion  The strong association with familiarity, the unexpected higher frequency of ALU (compared with the idiopathic variant) and the good response to replacement therapy means that familiarity should always be investigated. Furthermore, routine haematological screening and tests for serum iron, folic acid and vitamin B12 deficiencies should be assessed in all patients with recurrent aphthosis to treat any nutritional deficiency and to prevent more important related systemic manifestations.

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