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All Journal Dental Journal (Majalah Kedokteran Gigi) Journal of Dentomaxillofacial Science Journal of Case Reports in Dental Medicine
Erni Marlina
Bagian Ilmu Penyakit Mulut Fakultas Kedokteran Gigi Universitas Hasanuddin, Makassar Indonesia
Dentistry Health Professions

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Journal : Journal of Case Reports in Dental Medicine

 1 
Hypercobalaminemia in recalcitrant oral ulcers: A case report and literature review Erni Marlina; Andi AM. Putri; Ihda R. Nisaa
Journal of Case Reports in Dental Medicine Vol 5, No 1 (2023)
Publisher : Hasanuddin University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20956/jcrdm.v5i1.215

Abstract

Objective: Measuring levels of cobalamin (vitamin B12) in blood is frequently utilized to diagnosis deficiency in patients with recurrent oral ulceration. This article aims to report an interesting rare case of recurrent oral ulceration with a high level of cobalamin.Methods: a 44-year-old female came to dental clinic with chief complaint of recalcitrant oral ulceration since half a year ago. Patients basically had history of periodic oral ulcer for quite long time with short occurrence and only one or two ulcer in one period. However, the ulcer become alarming after she was hospitalized due to extreme fatigue. Patients subsequently instructed for routine blood along with cobalamin and IgE total examination.Results: The test came back with highly decreased level of red blood index indicates that the patients on severe anemic condition. Unexpectedly, the levels of cobalamin in blood increased by 70% from the referral score. Patients urgently refer for hospitalization to recover her Hb level. After blood transfusion, patients discharged from the hospital but under hematologic observation for the exact etiology of her anemia, including the high cobalamin level. After two months observation, patients Hb gained normal level, however the vitamin B12 level remain. Patients reported decreased in number of ulcers.Conclusion:  It is worthy to always check on cobalamin level for patients with recurrent oral ulcers since lower level can directly causing it or the high level can lead to some life-threatening diseases which can also trigger the recalcitrant oral ulcers.
Management of recalcitrant ulcer in elderly patients with anemia: A case report Erni Marlina; Nur A. Usman; Masita Rahayu
Journal of Case Reports in Dental Medicine Vol 4, No 3 (2022)
Publisher : Hasanuddin University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20956/jcrdm.v4i3.212

Abstract

Objective: This case report aimed to answer challenging in the treatment of chronic recalcitrant ulcers in elderly complicated by anemic condition. A 68 years old female patient came to Hasanuddin University Dental Hospital with chief complaint of recalcitrant painful canker sores affecting mouth and throat.Methods: Elder age could contribute in difficulty swallowing due to reduced saliva, slow eating habit, lost or caries teeth which lead to a less efficiency in the absorption of important nutrients such as iron and folic acid. This condition triggers a recalcitrant but chronic ulcer which in the end would add more difficulties for swallowing. A part from the pale conjunctiva of the eye, there was no other abnormality found extra orally. Drug therapy Bcom 150 mg with chlorhexidine gluconate 0.2% mouthwash and systemic corticosteroid.Results: Blood screening results demonstrated lower hemoglobin level with 11.6 and hematocrit 35.6 with referred value of 12 and 37, respectively. Long visit was needed to slowly adapted patient oral environment with local condition, as well as from systemic background improvement. Recalcitrant but chronic ulcers might be challenging in the treatment due to variabilities contributed factors such as age, unhealthy-eating habits, systemic background, and local oral hygiene and condition. One should be careful and be patient in changing the long behavior of the patient.Conclusion: Most importantly, patient been given advice to change her eating behaviors by consume more iron and folic acid food, and avoid irritant food. Local irritant of element 45 also been grinded.
Co-Authors Ali Yusran Andi A. Mauliana Andi AM. Putri Athifah Athifah Cane Lukisari Dwi Setianingtyas Felicia Eda Haryanto Harlina Harlina Harlina Ilmar Ihda R. Nisaa Israyani Israyani M. Jusri Masita Rahayu N. Nafiah Nur A. Usman Paulus Budi Teguh Sumintarti Sumintarti Sumintarti Sumintarti Sumintarti Sumintarti Zohra Nazaruddin