Serum ferritin in recurrent oral ulceration

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Abstract
A sensitive radioassay for ferritin was developed and used to examine serum ferritin levels in 105 patients with recurrent oral ulceration (ROU), 41 patients with Behcet''s syndrome (BS), 42 with other ulcerative oral lesions, 35 patients with nonulcerative oral lesions and in 78 controls. Ferritin levels increased with age and were significantly higher in males than females. The mean ferritin concentrations in male patients with ROU, BS or with other oral ulcers were significantly reduced in comparison with controls, and in female patients were significantly reduced in those with major aphthous ulcers. The prevalence of low serum ferritin levels was .apprx. 8% in patients with ROU, 15% in BS and 9.5% in patients with other nonulcerative oral lesions, compared with < 3% in patients with other ulcerative oral lesions, compared with < 3% in patients with nonulcerative oral disorders and in controls. Most of the Fe-deficient patients were female. Serum ferritin levels did not directly correlate with serum Fe levels and may be a more accurate indicator of Fe deficiency. Furthermore, serum ferritin can distinguish between patients with true Fe deficiency and those with secondary sideropenia. In a small number of patients, oral ulceration may be a presenting sign of Fe deficiency, and in a further small proportion of patients, ROU already present will probably be exacerbated by concurrent Fe deficiency. Both groups will show a therapeutic response to correction of the Fe deficiency. Serum ferritin levels apparently are a useful part of the hematological investigations in patients with ROU.