Recurrent aphthous stomatitis – Etiology, serum autoantibodies, anemia, hematinic deficiencies, and management

Chun Pin Chiang, Julia Yu-Fong Chang, Yi Ping Wang, Yu Hsueh Wu, Yang Che Wu, Andy Sun

Research output: Contribution to journalArticlepeer-review

83 Citations (Scopus)


Recurrent aphthous stomatitis (RAS) is one of the most common oral mucosal diseases characterized by recurrent and painful ulcerations on the movable or nonkeratinized oral mucosae. Clinically, three types of RAS, namely minor, major, and herpetiform types, can be identified. RAS more commonly affects labial mucosa, buccal mucosa, and tongue. Previous studies indicate that RAS is a multifactorial T cell-mediated immune-dysregulated disease. Factors that modify the immunologic responses in RAS include genetic predisposition, viral and bacterial infections, food allergies, vitamin and microelement deficiencies, systemic diseases, hormonal imbalance, mechanical injuries, and stress. Our previous study found the presence of serum gastric parietal cell antibody, thyroglobulin antibody, and thyroid microsomal antibody in 13.0%, 19.4%, and 19.7% of 355 RAS patients, respectively. We also found anemia, serum iron, vitamin B12, and folic acid deficiencies, and hyperhomocysteinemia in 20.9%, 20.1%, 4.8%, 2.6%, and 7.7% of 273 RAS patients, respectively. Therefore, it is very important to examine the complete blood count, serum autoantibody, hematinic, and homocysteine levels in RAS patients before we start to offer treatments for RAS. Because RAS is an immunologically-mediated disease, topical and systemic corticosteroid therapies are the main treatments of choice for RAS.

Original languageEnglish
Pages (from-to)1279-1289
Number of pages11
JournalJournal of the Formosan Medical Association
Issue number9
Publication statusPublished - Sept 2019
Externally publishedYes


  • Gastric parietal cell antibody
  • Hematinic deficiency
  • Recurrent aphthous stomatitis
  • Thyroglobulin antibody
  • Thyroid microsomal antibody

ASJC Scopus subject areas

  • General Medicine


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