124 Journal of the College of Physicians and Surgeons Pakistan 2013, Vol. 23 (2): 124-127 INTRODUCTION Recurrent aphthous stomatitis (RAS) is a chronic relapsing, remitting oral mucosal disease, which persists for a variable period of time and affects nearly 50% of the world population. 1,2 Immunological factors, local trauma, genetic and microbial factors and haematinic deficiencies are the major predisposing factors. 1,2 Haematinic deficiencies (B12, folate, and iron) cause nutritional anaemia and is common among infants, young children, menstruating and pregnant women in developing countries. 3 RAS when uncomplicated, may be associated with haematinic deficiency since the latter causes atrophy of oral epithelium. 4 Thinning of the epithelium makes it more venerable to trauma and increases penetration of exogenous bacterial antigens, one of the factors implicated in RAS. 2 Several studies have suggested the importance of iron, folic acid and vitamin B12 deficiencies and nutritional intolerance; however, some controversies exist. Carrozzo found no statistically significant difference between the haematological parameters in RAS patients and control group, 5 whereas Porter reported complete elimination of RAS after haematinic replacement therapy. 6 Recent preliminary and controlled studies observed reduced or eliminated recurrences of RAS lesion and 74.1% RAS patients recovered when prescribed haematinic replacement therapy. 7 In Pakistan two and a half million people are nutritionally anaemic out of whom 11% were suffering from pernicious anaemia which causes oral ulceration, mucosal bleeding and glossitis. 8 Although RAS is a public health problem and nutritional anaemia is also prevalent in Pakistan, no work has been done to investigate any correlation between RAS and haematinic deficiencies. Very limited data is available regarding RAS which mainly described its correlation with intestinal parasitosis. 9 For this study, determination of association between RAS and vitamin B12, serum Ferritin, RBC Folate, haemoglobin, and haematocrit deficiency was the objective. METHODOLOGY This study was carried out at Outpatient Department (OPD) of Oral Health Sciences, Shaikh Zayed Federal Postgraduate Medical Complex, Lahore, from February to July 2008. Permission to carry out this study was taken from the Ethical Review Committee Ref. No. SZMC/IRB/536/338 and Institutional Review Board (IRB)-Number 1054, Shaikh Zayed Postgraduate Medical Institute, Lahore. It was a non-probability sampling technique. Study population comprised of two groups including Aphthous Group (AG) and Non- Aphthous Group (Non-AG). ORIGINAL ARTICLE Haematological Parameters and Recurrent Aphthous Stomatitis Nabiha Farasat Khan 1 , Mohammad Saeed 2 , Saima Chaudhary 3 and Farkhanda Ghafoor 4 ABSTRACT Objective: To find out the relationship between recurrent aphthous stomatitis (RAS) with deficiencies of haemoglobin, haematocrit, serum vitamin B12, serum Ferritin and red blood cells (RBC) Folate level. Study Design: An analytical cross-sectional study. Place and Duration of Study: Department of Oral Health Sciences, Shaikh Zayed Federal Postgraduate Medical Complex, Lahore, from February to July 2008. Methodology: Sixty consecutive subjects with active RAS were taken as the aphthous group; 60 age and gender matched subjects without RAS were as the Non-Aphthous group. Five milliliter blood was taken from both groups to evaluate the levels of serum B12, and RBC Folate through radio immuno assay and serum ferritin with enzyme linked immuno-sorbent assay tests. Complete blood count was carried out to determine the level of haemoglobin and haematocrit in both groups. Proportion of subjects with lower values was compared using 2 text of proportions with significance at p < 0.05. Results: Serum Ferritin (p = 0.001), haematocrit (p < 0.001), RBC Folate (p < 0.001) and serum B12 (p < 0.001) were significantly lower in the RAS group. Combined deficiency state (haemoglobin, serum Ferritin, haematocrit, RBC Folate and serum B12) was identified in 13% (n = 8) RAS patients. Conclusion: Frequency of haematinic deficiencies was high in RAS patients. Serum B12 and RBC Folate were significantly low in aphthous group. Key words: Recurrent aphthous stomatitis. Deficient haemoglobin. Haematocrit. Serum ferritin. Serum B12. RBC folate. 1 Department of Oral Pathology / Prosthodontics 2 , Bolan Medical College, Dental Section, Quetta. 3 Department of Oral Pathology / NHRC 4 , Shaikh Zayed Federal Postgraduate Medical Institute, Lahore. Correspondence: Dr. Nabiha Farasat Khan, Bolan Student Hotel, Brewery Road, Quetta. E-mail: nabihasaeed@hotmail.com Received October 08, 2010; accepted November 28, 2012.