Perception of iron deficiency from oral mucosa alterations that show a high prevalence of Candida infection

Background/Purpose Iron deficiency (ID) is the most common cause of anemia. The aim of this study was to investigate patients with oral mucosa alterations as the initial manifestation of ID or ID anemia (IDA). Methods Sixty-four patients (50 IDA and 14 ID) with a wide range of sore mouth were diagno...

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Bibliographic Details
Published in:Journal of the Formosan Medical Association 2016-08, Vol.115 (8), p.619-627
Main Author: Lu, Shin-Yu
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Anemia, Iron-Deficiency - complications
Antifungal Agents - therapeutic use
Candida
Candidiasis, Oral - complications
Candidiasis, Oral - drug therapy
Erythrocyte Indices
Female
Ferritins - blood
Hemoglobins - analysis
Humans
Incidence
Internal Medicine
Iron - blood
iron deficiency anemia
Male
Middle Aged
Mouth Mucosa - microbiology
Mouth Mucosa - pathology
oral candidosis
oral mucosa alterations
Severity of Illness Index
Taiwan
Young Adult
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Summary:Background/Purpose Iron deficiency (ID) is the most common cause of anemia. The aim of this study was to investigate patients with oral mucosa alterations as the initial manifestation of ID or ID anemia (IDA). Methods Sixty-four patients (50 IDA and 14 ID) with a wide range of sore mouth were diagnosed and treated. The oral and physical manifestations as well as iron studies and anemia classification based on the mean and heterogeneity of red cell size were assessed. Results ID predisposed 64 patients to a high incidence of Candida infection (85%) and showed a variety of oral manifestations including angular cheilitis (63%), atrophic glossitis (AG; 59%), pseudomembranous candidosis (44%), erythematous candidosis (41%), median rhomboid glossitis (5%), chronic mucocutaneous candidosis (5%), papillary hyperplastic candidosis (3%), and cheilocandidosis (3%). Others included pale oral mucosa (31%), burning mouth (28%), and recurrent oral ulcers (6%). Colorectal cancers in two patients were diagnosed. The values of hemoglobin (Hb) in 64 ID patients varied from normal to life-threatening levels, but none had developed advanced systemic symptoms except fatigue. All had low serum iron and ferritin. Sixty (94%) patients had transferrin saturation 
ISSN:0929-6646
DOI:10.1016/j.jfma.2016.03.011