Clinical analysis of vitamin B₁₂ deficiency mainly manifested by recurrent aphthous ulcers

To analyze the clinical characteristics and treatment experience of Vitamin B₁₂ (VB₁₂) deficient patients with recurrent aphthous ulcers (RAU) to improve the clinical efficacy.

A retrospective analysis was performed on 15 cases of recurrent oral ulcers from January 2016 to September 2018. The causes were analyzed according to the patients’clinical characteristics.

In total, 15 patients with RAU had no remission after routine immunotherapy. Further clinical examination suggested that vitamin B₁₂ levels were reduced. The erythrocyte mean corpuscular volume (MCV) was significantly increased, and the average number of red blood cells (RBC) and hemoglobin (Hb) levels were decreased. RAU disappeared after vitamin B₁₂ supplementation. Routine blood work showed that the MCV returned to the normal range, which was statistically significant compared with the pretreatment MCV (P < 0.001). Vitamin B₁₂ serum levels were significantly higher (P < 0.001) than those before treatment.

When the main manifestation of vitamin B₁₂ deficiency is recurrent oral ulcer symptoms, dentists should examine the lesions carefully, inquire about the medical history in detail, and perform further serological tests when necessary to avoid the over-use of immunosuppressive drugs for treatment.