Oral manifestations in vitamin B(12) deficiency patients with or without history of gastrectomy

BACKGROUND: The purpose of this study was to compare clinical features of vitamin B(12) deficiency patients with a history of gastrectomy to those without a history of gastrectomy. METHODS: Twenty-two patients with vitamin B(12) deficiency were included. Patients’ chief complaints, oral manifestations, blood examination results, and past medical histories were reviewed. RESULTS: Eleven patients had a history of gastrectomy and 11 did not. The chief complaint was glossodynia in all patients. No significant differences were observed between the two groups regarding age, sex, symptom duration, or plasma vitamin B(12) level. Erythema and depapillation of the tongue were the most common findings, however less common among patients without a history of gastrectomy. Two patients with a history of gastrectomy and 5 patients without a history of gastrectomy had normal oral mucosa. Patients with a history of gastrectomy were more anemic. Oral symptoms of the majority of patients responded to antifungals and vitamin B(12) replacement. The suggested etiologies for vitamin B(12) deficiency in the patients without a history of gastrectomy were gastritis, medications, diet, autoimmunity, and early gastric cancer. CONCLUSIONS: Vitamin B(12) deficiency and its associated etiological factors should be considered in patients with glossodynia, even those whose oral mucosa appears normal and who lack a history of gastrectomy.