Glossitis Induced by Vitamin B12 Deficiency. Clinical Investigation of Four Cases.

DOI Sayoko, YONEDA Kazunori, YAMAMOTO Tetsuya, UETA Eisaku, KIMURA Tsuyoshi, MORI Hitoshi, OSAKI Tokio

doi:10.11277/stomatology1952.49.278

We herein report on four patients with glossitis induced by vitamin B₁₂ (VB₁₂) deficiency. Of the four patients, who complained of glossal pain and who had on prior history of medical consultation (patient A, an 83-year-old female; patient B, an 81-year-old female; patient C, a 59-year-old female; patient D, a 68-year-old male), patients C and D had undergone gastrectomy. In patients A and B, anti-parietal cell antibody was elevated to>80, and atrophic gastritis was ascertained by endoscopic examination. Red blood cell counts were 336, 192, 382, and 358×10⁴/μl, and hemoglobin levels were 12.6, 8.2, 12.8, and 12.7g/dl, in patients A, B, C, and D, respectively. Mean cell volume (MCV) increased to 106 to 128μ³ in three patients, although MCV only slightly elevated in patient C (103μ³). The levels of serum VB₁₂ in patients A, B, C, and D were 48, 23, 8, and 110 pg/ml, respectively. With these findings, glossal pain thresholds and salivary flow rates (SFR) were largely decreased in all of the patients. The patients were treated with intravenous/oral VB₁₂, and all of them except patient A were given oral iron (Fe). With treatment for about 3 weeks, glossal pain disappeared, and reformation of the glossal papillae was observed, in parallel with increases of serum VB₁₂ levels. The improvement of the glossal condition was also supported by increases of pain thresholds and nonstimulated SFRs. These clinical findings indicate that VB₁₂ deficiency may induce glossal pain as the first symptom, accompanying decreases of the glossal pain threshold, non-stimulated SFR, and the serum Fe level, and that estimation of the serum VB₁₂ level and MCV is required for diagnosis of glossal pain, especially in patients with a history of total gastrectomy.

Glossitis Induced by Vitamin B12 Deficiency. Clinical Investigation of Four Cases.

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