- 期刊
Initial Diagnosis of Vitamin B12 Deficiency by Sore Mouth and Assessment of the Red Blood Cell Distribution Width, Mean Corpuscular Volume, and Hemoglobin Level-A Preliminary Study
並列摘要
The oral manifestations of glossodynia, glossitis, and stomatitis in vitamin B12 deficiency have long been recognized. These oral changes may occur in the preanemic stage. The aim of this paper was to study the red blood cell distribution width (RDW), mean corpuscular volume (MCV), and hemoglobin (Hb) level in 34 patients with a wide range of oral symptoms and signs as the initial manifestations of vitamin B12 deficiency. Of the 34 patients, 29 were normal to mildly anemic, and 5 were moderately to severely anemic; none had generalized symptoms sufficient to arouse suspicion of micronutrient deficiency or anemia before they visited the Oral Medicine Clinic. Nine (26.4%) of the 34 patients had normal RDWs and 8 (88.9%) of these 9 patients also had normal MCVs. Overall, 13 (38.2%) of the 34 patients had normal MCVs and 3 (8.8%) had low MCVs. Our findings indicate that the classic presentation of macrocytic heterogeneous anemia in vitamin B12 deficiency does not hold true in a large proportion of cases, and the increase of RDW is not necessarily the earliest indicator of vitamin B12 deficiency. Therefore, a diagnosis of vitamin B12 deficiency should be considered even in patients with normal Hb levels and low or normal MCVs. Nevertheless, the combined increase in the RDW and MCV in patients with a sore mouth is still a useful indicator of possible vitamin B12 deficiency after folate deficiency and chronic diseases have been ruled out.
延伸閱讀
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