Journal of Dental Sciences
Volume 5, Issue 1 , Pages 41-46, March 2010

Dramatic recovery from severe anemia by resolution of severe periodontitis

  • Shin-Yu Lu

      Affiliations

    • Department of Oral Pathology and Family Dentistry, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan
    • Corresponding Author InformationCorresponding author. Department of Oral Pathology and Family Dentistry, Chang Gung Memorial Hospital, 123, Da-Pi Road, Niaosong Township, Kaohsiung County 83301, Taiwan
    • ,
  • Hock-Liew Eng

      Affiliations

    • Department of Pathology, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan

Received 2 November 2009; accepted 19 February 2010.

Article Outline

Periodontal infections were previously found to be associated with systemic diseases such as diabetes, stroke, cardiovascular disease, bacterial pneumonia, and preterm low births. Individuals with gum disease have increased concentrations of circulating inflammatory markers that contribute to systemic inflammation, and periodontitis may tend towards anemia because of depressed erythropoiesis. Anemia of chronic disease (ACD) is defined as anemia that occurs during infections, inflammation, neoplasia, and a wide range of diseases including renal, endocrine and cardiovascular diseases. The etiology of ACD is multifactorial, but is often under-recognized and undertreated. This article describes an unusual case of severe anemia caused by severe periodontitis in a 50-year-old woman. After extracting many hopeless teeth, resolving the periodontitis and making new dentures, a dramatic recovery from the severe anemia was obvious 4 months later, and her health-related quality of life vastly improved. All blood values returned to normal with no medication. Chronic periodontitis can be a cause of ACD. The diagnosis of ACD based on the mean size and heterogeneity of red blood cells and an iron study, such as serum iron and ferritin, is discussed.

Key Words:  anemia of chronic disease , periodontitis

No full text is available. To read the body of this article, please view the PDF online.

 

Back to Article Outline

References 

  1. Beck J , Garcia R , Heiss G , Vokonas PS , Offenbacher S . Periodontal disease and cardiovascular disease . J Periodontol . 1996;67:1123–1137
  2. Ebersole JL , Machen RL , Steffen MJ , Willmann DE . Systemic acute-phase reactants, C-reactive protein and heptoglobin, in adult periodontitis . Clin Exp Immunol . 1997;107:347–352
  3. Li X , Kolltveit KM , Tronstad L , Olsen I . Systemic diseases caused by oral infection . Clin Microbiol Rev . 2000;13:547–558
  4. Taylor BA , Tofler GH , Carey HMR , et al.   Full-mouth tooth extraction lowers systemic inflammatory and thrombotic markers of cardiovascular risk . J Dent Res . 2006;85:74–78
  5. Aiuto FD , Parkar M , Andreou G , et al.   Periodontitis and systemic inflammation: control of local infection is associated with a reduction in serum inflammatory markers . J Dent Res . 2004;83:156–160
  6. Hutter JW , Velden Uvd , Varoufaki A , Huffels RAM , Hoek FJ , Loos BG . Lower numbers of erythrocytes and lower levels of hemoglobin in periodontitis patients compared to control subjects . J Clin Periodontol . 2001;28:930–936
  7. Weiss G . Pathogenesis and treatment of anemia of chronic disease . Blood Rev . 2002;16:87–96
  8. Weiss G , Goodnough LT . Anemia of chronic disease . N Eng J Med . 2005;352:1011–1023
  9. Cartwright GE , Lee GR . The anaemia of chronic disorders . Br J Haematol . 1971;21:147–152
  10. Mulherin D , Skelly M , Saunder A , et al.   The diagnosis of iron deficiency in patients with rheumatoid arthritis and anemia; an algorithm using simple laboratory measures . J Rheumatol . 1996;23:237–240
  11. Cash JM , Sears DA . The anemia of chronic disease: Spectrum of associated diseases in a series of unselected hospitalized patients . Am J Med . 1989;87:638–644
  12. Chernow B , Wallner SF . Is the anemia of chronic disorders normocytic-normochromic? . Mil Med . 1978;143:345–346
  13. Bessman JD , Gilmer PR , Gardner FH . Improved classification of anemias by MCV and RDW . Am J Clin Pathol . 1983;80:322–326
  14. Garry PJ , Goodwin JS , Hunt WE . Iron status and anemia in the elderly: new findings and a review of previous studies . J Am Geriatr Soc . 1983;31:389–399
  15. Lu SY , Wu HC . Initial diagnosis of anemia from sore mouth and improved classification of anemias by MCV and RDW in 30 patients . Oral Surg Oral Med Oral Pathol Oral Radiol Endod . 2004;98:679–685
  16. Lu SY , Wang MC , Eng HL . Initial diagnosis of B12 deficiency from sore mouth and assessment of their RDW, MCV and hemoglobin in 34 patients . J Dent Sci . 2006;1:23–31
  17. Weinberg ED . Iron loading and disease surveillance . Emerg Infect Dis . 1999;5:346–352
  18. Zucker S , Friedman S , Lysik RM . Bone marrow erythropoiesis in the anemia of infection, inflammation, and malignancy . J Clin Invest . 1974;53:1132–1138

PII: S1991-7902(10)60007-4

doi:10.1016/S1991-7902(10)60007-4

Journal of Dental Sciences
Volume 5, Issue 1 , Pages 41-46, March 2010

Article Tools