Rekürren Aftöz Stomatit Hastalarının Laboratuvar Bulguları

Bahar Sevimli Dikicier; Mahizer Yaldız; Büşra Aydın

doi:10.34084/bshr.582592

Research Article

Rekürren Aftöz Stomatit Hastalarının Laboratuvar Bulguları

Year 2019, Volume: 3 Issue: 2, 96 - 99, 29.08.2019

Bahar Sevimli Dikicier Mahizer Yaldız Büşra Aydın

https://doi.org/10.34084/bshr.582592

Abstract

Giriş: Rekürren aftöz stomatit (RAS), günümüzde etyolojisi halen aydınlatılamamış hastalıklar arasındadır ve çoğunlukla sağlıklı kişilerde ortaya çıkar. Lokal ve sistemik koşullar ile genetik, immünolojik ve mikrobial faktörlerin patogenezde rol oynadığı düşünülmektedir. Oral aftlar; Behçet hastalığı , Reiter sendromu, rekürren eritema multiforme, Çölyak hastalığı, inflamatuar barsak hastalıkları, kollajen doku hastalıkları, AIDS, periyodik ateş, farenjit ve adenit (PFAPA) sendromu) gibi bazı sistemik hastalıklarıla birlikte görülebilmektedir. Bu nedenle RAS tanısı koyulurken oral ülserasyonlarla seyreden hastalıkların ayırıcı tanısı yapılmalıdır. Öykü ve fizik muayene sonrası, tam kan sayımı, B12, demir, folik asit yetersizliğinin değerlendirilmesi için testler istenmeli, replasman gereken durumlar saptanmalıdır.

Materyal ve metot: Dermatoloji polikliniğimize başvuran, RAS ayırıcı tanısı yapılıp buna neden olan herhangi bir sistemik hastalık tanısı almayan hastaların kan sayımı, sedimantasyon (sed), C-reaktif protein (CRP), serum demiri (SD), demir bağlama kapasitesi (DBK), vitamin B12, folik asit, vitamin D ve HBsAg, anti HCV, anti HIV tetkiklerinin sonuçları kayıtlardan incelenerek cinsiyetlere göre karşılaştırmalı olarak değerlendirildi.

Bulgular: Kırk beş hastanın laboratuvar bulgularının incelendiği çalışmada hastaların yaş ortalaması 33,9 (11-66) idi. Hastaların 23’ü kadın, 22’si erkeklerden oluşmaktaydı. Cinsiyetler arasında yaş ortalamaları benzerdi, kadınlarda 36, erkeklerde 30. Hemoglobin düzeyleri kadınlarda erkeklere göre anlamlı olarak düşüktü (p=,000). Serum demiri ve demir bağlama kapasitesi ölçümleri de kadınlarda erkeklere göre anlamlı düzeyde düşük bulundu (p=,000). Vitamin B12, folik asit,, vitamin D düzeyleri ve CRP düzeyleri kadınlar ve erkekler arasında benzer düzeylerde ve D vitamini düzeyi dışında referans aralıklar içindeydi.

Sonuç: RAS tanısı koyulan hastalarda, D vitamini düzeyleri cinsiyet fark etmeksizin tümünde referans değerin altında saptanmıştır. Daha geniş çaplı kontrollü çalışmalarla D vitamini düzeyinin etyopatogenezdeki rolünün incelemeye değer olduğunu düşünmekteyiz.

Keywords

Oral aft, rekürren aftöz stomatit, D vitamini yetersizliği, anemi

References

1. Zeynep Topkarcı. Zorlu Oral Hastalıklarda Güncel Tedavi: Rekürren Oral Aftozis Türkderm 2012; 46 Özel Sayı 2: 123-9).
2. Porter SR, Scully C, Pedersen A. Recurrent aphthous stomatitis. Crit Rev Oral Biol Med. 1998;9(3):306–321.
3. Compilato D1, Carroccio A, Calvino F, et al. Hematological deficiencies in patients with recurrent aphthosis. J Eur Acad Dermatol Venereol. 2010;24(6):667–673.
4. Epidemiologic aspects of recurrent aphthous ulcerations.Ship II Oral Surg Oral Med Oral Pathol. 1972;33(3):400-6.
5. Recurrent aphthous stomatitis: clinical characteristics and associated systemic disorders.Rogers RS 3rdSemin Cutan Med Surg. 1997;16(4):278-83.
6. Ship JA, Chavez EM, Doerr PA, Henson BS, Sarmadi M. Recurrent aphthous stomatitis. Quintessence Int. 2000;31(2):95-112.
7. Woo SB, Greenberg MS. Ulcerative, vesicular and bullous lesions. In: Greenberg MS, Glick M, Ship JA, editors. Burket’s Oral Medicine. 11. Hamilton, Canada: BC Decker; 2008: 41–76.
8. Crispian Scully CBE. The oral cavity and lips. In: Burns T, Breathnach S, Cox N, Griffiths C, eds. Rook’s Textbook of Dermatology. 7th ed. Oxford: Blackwell Science Ltd; 2004:66-43.
9. Scully C, Gorsky M, Lozada-Nur F. The diagnosis and management of recurrent aphthous stomatitis: a consensus approach. J Am Dent Assoc 2003;134:200-7.10. Nilgün Solak Tekin,Selim Aydemir,Tuna Sezer,Sibel Duysak, H. Cevdet Altınyazar. Rekürren Aftöz Stomatitli Hastalarda Hematolojik Değişiklikler. Turkiye Klinikleri J Dermatol. 2007;17(3):150-4.
10. Nilgün Solak Tekin,Selim Aydemir,Tuna Sezer,Sibel Duysak, H. Cevdet Altınyazar. Rekürren Aftöz Stomatitli Hastalarda Hematolojik Değişiklikler. Turkiye Klinikleri J Dermatol. 2007;17(3):150-4.
11. Öztekin A, Öztekin C. Vitamin D levels in patients with recurrent aphthous stomatitis. BMC Oral Health. 2018 Nov 9;18(1):186.
12. Khabbazi A, Ghorbanihaghjo A, Fanood F, et al. A comparative study of vitamin D serum levels in patients with recurrent aphthous stomatitis. Egypt Rheumatol. 2014;37:133–137.
13. Krawiecka E, Ślebioda Z, Szponar E, Kowalska A, Dorocka-Bobkowska B. Vitamin D status in recurrent aphthous stomatitis. Postepy Dermatol Alergol. 2017;34(6):612–617.
14. Piskin S, Sayan C, Durukan N,Senol M. Serum iron, ferritin, folic acid, andvitamin B12 levels in recurrent aphthous stomatitis.J Eur Acad Dermatol Venereol.2002 Jan;16(1):66-7.
15. Porter SR, Scully C, Flint S. Hematologic status in recurrent aphthous stomatitis compared with other oral disease. Oral Surg Oral Med Oral Pathol 1988;66:41-44.
16. Myszka M, Klinger M. The immunomodulatory role of vitamin D. Postepy Hig Med Dosw 2014; 68: 865-78.
17. Adorini L, Penna G, Giarratana N, et al. Dendritic cells as targets for immunomodulation by vitamin D receptor ligands. J Steroid Biochem Mol Biol 2004; 89-90: 437-41.
18. Karagün E, Ergin C, Baysak S, et al. The role of serum vitamin D levels in vitiligo. Adv Dermatol Allergol 2016; 33: 300-2.
19. Bachtiar EW, Cornain S, Siregar B, Raharjo TW. Decreased CD4+/CD8+ ratio in major type of recurrent aphthous ulcers: comparing major to minor types of ulcers. Asian Pac J Allergy Immunol 1998; 16: 75-9.
20. Buno IJ, Huff C, Weston WL, et al. Elevated levels of interferon gamma, tumor necrosis factor alpha, interleukins 2, 4 and 5, but not interleukin 10, are present in recurrent aphthous stomatitis. Arch Dermatol 1998; 134: 827-31.
21. Häyrinen-Immonen R, Nordström D, Malmström M, et al. Immune-inflammatory cells in recurrent oral ulcers (ROU). Scand J Dent Res 1991; 99: 510-8.

Laboratory Findings of Patients with Recurrent Aphthous Stomatitis

Year 2019, Volume: 3 Issue: 2, 96 - 99, 29.08.2019

Bahar Sevimli Dikicier Mahizer Yaldız Büşra Aydın

https://doi.org/10.34084/bshr.582592

Abstract

Objective: Recurrent aphthous stomatitis
(RAS) is one of the aetiology of unexplained disease and occurs mostly in
healthy individuals. Differential diagnosis of Behçet's disease, Reiter's syndrome,
recurrent erythema multiforme, celiac disease, inflammatory bowel diseases,
collagen tissue diseases, AIDS, periodic fever, pharyngitis and adenitis (PFAPA
syndrome) should be made. After history and physical examination, complete
blood count, B12, iron, folic acid and vitamin D deficiency should be evaluated
and cases requiring replacement should be determined. The aim of this study was
to evaluate hematological changes in patients with RAS.

Material and Methods: Blood count,
sedimentation, C-reactive protein, serum iron, iron binding capacity, vitamin
B12 , folic acid, 25 hydroxy vitamin D and HBsAg, anti HCV and anti HIV tests
were evaluated from records and evaluated comparatively according to gender.

Results: The mean age of the patients
was 33.9 (11-66) years. 23 of the patients were female and 22 were male. Mean
age of the genders was similar, 36 in women and 30 in men. Hemoglobin levels
were significantly lower in women than in men (p =, 000). Serum iron and iron
binding capacity measurements were significantly lower in women (p =, 000).
Vitamin B12, folic acid, vitamin D levels and CRP levels were similar between
women and men and were within the reference ranges except vitamin D levels.
HBsAg, anti HCV and anti HIV positivity were not found.

Conclusion: Vitamin D levels were found
to be below the reference value in all patients regardless of gender. These
findings suggest that the role of these findings in etiopathogenesis should be
examined with larger controlled studies.

Keywords

Oral aphtae, recurrent aphthous stomatitis, vitamin D deficiency, anemia

References

1. Zeynep Topkarcı. Zorlu Oral Hastalıklarda Güncel Tedavi: Rekürren Oral Aftozis Türkderm 2012; 46 Özel Sayı 2: 123-9).
2. Porter SR, Scully C, Pedersen A. Recurrent aphthous stomatitis. Crit Rev Oral Biol Med. 1998;9(3):306–321.
3. Compilato D1, Carroccio A, Calvino F, et al. Hematological deficiencies in patients with recurrent aphthosis. J Eur Acad Dermatol Venereol. 2010;24(6):667–673.
4. Epidemiologic aspects of recurrent aphthous ulcerations.Ship II Oral Surg Oral Med Oral Pathol. 1972;33(3):400-6.
5. Recurrent aphthous stomatitis: clinical characteristics and associated systemic disorders.Rogers RS 3rdSemin Cutan Med Surg. 1997;16(4):278-83.
6. Ship JA, Chavez EM, Doerr PA, Henson BS, Sarmadi M. Recurrent aphthous stomatitis. Quintessence Int. 2000;31(2):95-112.
7. Woo SB, Greenberg MS. Ulcerative, vesicular and bullous lesions. In: Greenberg MS, Glick M, Ship JA, editors. Burket’s Oral Medicine. 11. Hamilton, Canada: BC Decker; 2008: 41–76.
8. Crispian Scully CBE. The oral cavity and lips. In: Burns T, Breathnach S, Cox N, Griffiths C, eds. Rook’s Textbook of Dermatology. 7th ed. Oxford: Blackwell Science Ltd; 2004:66-43.
9. Scully C, Gorsky M, Lozada-Nur F. The diagnosis and management of recurrent aphthous stomatitis: a consensus approach. J Am Dent Assoc 2003;134:200-7.10. Nilgün Solak Tekin,Selim Aydemir,Tuna Sezer,Sibel Duysak, H. Cevdet Altınyazar. Rekürren Aftöz Stomatitli Hastalarda Hematolojik Değişiklikler. Turkiye Klinikleri J Dermatol. 2007;17(3):150-4.
10. Nilgün Solak Tekin,Selim Aydemir,Tuna Sezer,Sibel Duysak, H. Cevdet Altınyazar. Rekürren Aftöz Stomatitli Hastalarda Hematolojik Değişiklikler. Turkiye Klinikleri J Dermatol. 2007;17(3):150-4.
11. Öztekin A, Öztekin C. Vitamin D levels in patients with recurrent aphthous stomatitis. BMC Oral Health. 2018 Nov 9;18(1):186.
12. Khabbazi A, Ghorbanihaghjo A, Fanood F, et al. A comparative study of vitamin D serum levels in patients with recurrent aphthous stomatitis. Egypt Rheumatol. 2014;37:133–137.
13. Krawiecka E, Ślebioda Z, Szponar E, Kowalska A, Dorocka-Bobkowska B. Vitamin D status in recurrent aphthous stomatitis. Postepy Dermatol Alergol. 2017;34(6):612–617.
14. Piskin S, Sayan C, Durukan N,Senol M. Serum iron, ferritin, folic acid, andvitamin B12 levels in recurrent aphthous stomatitis.J Eur Acad Dermatol Venereol.2002 Jan;16(1):66-7.
15. Porter SR, Scully C, Flint S. Hematologic status in recurrent aphthous stomatitis compared with other oral disease. Oral Surg Oral Med Oral Pathol 1988;66:41-44.
16. Myszka M, Klinger M. The immunomodulatory role of vitamin D. Postepy Hig Med Dosw 2014; 68: 865-78.
17. Adorini L, Penna G, Giarratana N, et al. Dendritic cells as targets for immunomodulation by vitamin D receptor ligands. J Steroid Biochem Mol Biol 2004; 89-90: 437-41.
18. Karagün E, Ergin C, Baysak S, et al. The role of serum vitamin D levels in vitiligo. Adv Dermatol Allergol 2016; 33: 300-2.
19. Bachtiar EW, Cornain S, Siregar B, Raharjo TW. Decreased CD4+/CD8+ ratio in major type of recurrent aphthous ulcers: comparing major to minor types of ulcers. Asian Pac J Allergy Immunol 1998; 16: 75-9.
20. Buno IJ, Huff C, Weston WL, et al. Elevated levels of interferon gamma, tumor necrosis factor alpha, interleukins 2, 4 and 5, but not interleukin 10, are present in recurrent aphthous stomatitis. Arch Dermatol 1998; 134: 827-31.
21. Häyrinen-Immonen R, Nordström D, Malmström M, et al. Immune-inflammatory cells in recurrent oral ulcers (ROU). Scand J Dent Res 1991; 99: 510-8.

There are 21 citations in total.

Details

Primary Language	Turkish
Subjects	Clinical Sciences
Journal Section	Research Article
Authors	Bahar Sevimli Dikicier 0000-0002-1912-3946 Mahizer Yaldız This is me Büşra Aydın
Publication Date	August 29, 2019
Acceptance Date	July 22, 2019
Published in Issue	Year 2019 Volume: 3 Issue: 2

Cite

AMA	Sevimli Dikicier B, Yaldız M, Aydın B. Rekürren Aftöz Stomatit Hastalarının Laboratuvar Bulguları. J Biotechnol and Strategic Health Res. August 2019;3(2):96-99. doi:10.34084/bshr.582592

Download Cover Image

Article Files

Full Text

Dergimiz Uluslararası hakemli bir dergi olup TÜRKİYE ATIF DİZİNİ, TürkMedline, CrossREF, ASOS index, Google Scholar, JournalTOCs, Eurasian Scientific Journal Index(ESJI), SOBIAD ve ISIindexing dizinlerinde taranmaktadır. TR Dizin(ULAKBİM), SCOPUS, DOAJ için başvurularımızın sonuçlanması beklenmektedir.