Anemia, hematinic deficiencies, hyperhomocysteinemia, and serum gastric parietal cell antibody positivity in oral lichen planus patients with vitamin B12 deficiency

Background/purpose: Our previous study found that 60 of 588 oral lichen planus (OLP) patients have vitamin B12 deficiency. This study assessed whether the vitamin B12-deficient OLP (B12D/OLP) patients had significantly higher frequencies of anemia, hematinic deficiencies, hyperhomocysteinemia, and serum gastric parietal cell antibody (GPCA) positivity than healthy control subjects and evaluated whether all B12D/OLP patients had pernicious anemia (PA). Materials and methods: The blood hemoglobin (Hb) and serum iron, vitamin B12, folic acid, homocysteine, and GPCA levels in 60 B12D/OLP patients and 588 healthy control subjects were measured and compared. Results: We found that 60 B12D/OLP patients had significantly lower mean blood Hb and serum iron, vitamin B12, and folic acid levels as well as significantly higher mean corpuscular volume (MCV) and mean serum homocysteine level than 588 healthy control subjects (all P-values <0.01). Moreover, 60 B12D/OLP patients had significantly higher frequencies of macrocytosis (55.0 %), blood Hb (68.3 %) and serum iron (31.7 %) and vitamin B12 (100.0 %) deficiencies, hyperhomocysteinemia (91.7 %), and serum GPCA positivity (66.7 %) than 588 healthy control subjects (all P-values <0.001). The four most common types of anemia in 41 anemic B12D/OLP patients were PA (17 patients, 41.5 %), normocytic anemia (12 patients, 29.3 %), iron deficiency anemia (6 patients, 14.6 %), and macrocytic anemia other than PA (5 patients, 12.2 %). Conclusion: The B12D/OLP patients have significantly higher frequencies of macrocytosis, blood Hb and serum iron and vitamin B12 deficiencies, hyperhomocysteinemia, and serum GPCA positivity than healthy control subjects. Only 17 (28.3 %) of 60 B12D/OLP patients have PA.