Cyanocobalamin May be Beneficial in the Treatment of Recurrent Aphthous Ulcers Even When Vitamin B12 Levels Are Normal

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ABSTRACT

Objective

To evaluate the efficacy of cyanocobalamin treatment in patients having recurrent aphthous ulcers (RAUs) with normal or decreased serum vitamin B12 (cobalamin) levels.

Methods

Seventy-two patients with RAU were included in the study. In addition to serum cobalamin levels, hemanitic and biochemistrical parameters were measured. Patients with serum cobalamin levels <140 pg/mL were defined as the cobalamin deficient group (CDG) whereas patients with cobalamin levels ≥140 pg/mL were defined as the cobalamin normal group (CNG). The degree of aphthous ulcer healing was determined according to serum cobalamin levels at the first and sixth month after cyanocobalamin treatment protocol.

Results

Of the 72 participants, 37 were in the CDG whereas 35 were considered to have normal cobalamin levels. In the first admission the cobalamin levels were 215.8 ± 116.90 pg/mL in CNG and 107.43 ± 29.35 pg/mL in the CDG. The frequency of aphthous ulcers was defined numerically according to monthly occurrence of the lesions. The mean aphthous ulcer frequency in CNG group was 1.9 ± 0.7, whereas it was 2.4 ± 0.9 in the CDG. A significant increase in cobalamin levels was observed after cyanocobalamin treatment in both groups. A significant decrease in aphthous ulcer frequency was also concurrently observed. 96% of the patients showed good response to replacement treatment, 4% of the study population did not respond to the treatment.

Conclusion

Cyanocobalamin treatment maybe beneficial for patients with RAU even when serum cobalamin levels are normal. We suggest that higher serum cobalamin levels should be attained in patients with RAU for mucosal protection.

Section snippets

Materials and Methods

Patients (n = 72; 46 females, 26 males) with RAUs admitted to Dumlupinar University Hospital, Department of Internal Medicine and Dentistry between January 2006 and June 2006 were recruited. All patients provided informed consent and necessary ethical approval was obtained.

After performing physical examination, serum cobalamin levels, hemoglobin, white blood cell, mean corpuscular volume, iron, total iron binding capacity, ferritin, folic acid, rheumatoid factor, and C-reactive protein levels were

Results

Thirty-seven patients (51.3%, 19 females, 18 males) with serum cobalamin levels lower than 140 pg/mL were in the CDG whereas 35 (48.6%, 27 females, 8 males) were in CNG with cobalamin levels higher than 140 pg/mL.

There was no statistically significant difference in levels of hemoglobin, mean corpuscular volume, white blood cell, iron, total iron binding capacity, ferritin, folic acid, and in smoking between 2 groups (P > 0.05) (Table 1). However significant differences in ages and platelet levels

Discussion

The correlation between recurrent aphthous stomatitis and cobalamin deficiency has been the subject of several recent studies.9., 10., 11., 12., 13., 14., 15. In some reports, it is stated that cobalamin deficiency might have an important role in the etiology of RAU.11., 12., 13., 14. Some others suggested that cobalamin levels might also be important in case of detecting the hemanitic disorders in patients with RAU.9., 10., 15. These studies suggest that there maybe a correlation between serum

Conclusion

Our study showed that cyanocobalamin treatment maybe beneficial for patients with RAU even when serum cobalamin levels are normal. We state that for mucosal protection, preventing recurrences and treatment of lesions, higher serum cobalamin levels (>500 pg/mL) should be achieved in patients with RAU. Clinicians and patients alike should keep in mind that cyanocobalamin treatment as an alternative therapy may have potential benefits.

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