title: [Atrophy of the oro-pharyngeal mucosa caused by vitamin B12 and folic acid deficiency. Etiopathologic aspects and clinico-therapeutic problems].
abstract: BACKGROUND
  By atrophy, the decrease in volume of the cell due to loss of cell substances is intended. When a sufficiently high number of cells is involved, the whole tissue or organ decreases in volume or becomes atrophic. The oropharyngeal mucous membrane can be the site of processes of mainly atrophic type whose causes can be found in various pathologies. These pathologies can be caused by alterations in the endocrin-metabolic conditions, such as vitamin deficiencies, especially of vitamin B12 and folic acid.
  
  
  METHODS
  Twenty-three patients who on objective examination were affected by mucous atrophies, both of the oral cavity and of the oropharyngeal area probably due to vitamin B12 and/or folic acid deficiency have been identified. Indicatively the therapies prescribed consisted of administration of N5calcium methyltetrahydrofolate for 1 month, and of pharmaceutical products containing vitamin B12, again for 1 month. After a month of therapy, the overall clinical situation of all the patients who were included in our protocol was reassessed.
  
  
  CONCLUSIONS
  On clinical examination, 20 patient showed pink oral mucous membrane. The patients also reported disappearance of pyrotic symptoms and the laboratory tests showed values within normal limits. The erethistic ulcers on the lips had disappeared even if the vermilion did not appear fully re-epithelialized in 9 patients. The other 3 patients, who still had values under normal limits, were subjects who had undergone long-term chemotherapy. For these patients the therapy was continued for a further month. At the third check-up and careful objective examination, the lingual mucous membrane appeared pink and re-epitheliated. The patients reported disappearance of the painful oral symptoms. The laboratory tests were repeated again for all the patients and these confirmed values within normal limits for vitamin B12 and folic acid.
authors.affiliation: Istituto Scientifico Ospedale S. Raffaele, Università degli Studi, Milano.
authors.forename: A
authors.initials: A
authors.lastname: Bottero
authors.forename: D
authors.initials: D
authors.lastname: Lauritano
authors.forename: F
authors.initials: F
authors.lastname: Spadari
authors.forename: M
authors.initials: M
authors.lastname: Zambellini Artini
authors.forename: A
authors.initials: A
authors.lastname: Salvato
mesh_terms: D000328:Adult; D000752:Anemia, Pernicious / Q000150:complications / Q000628:therapy; D001284:Atrophy / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D002118:Calcium / Q000627:therapeutic use; D005260:Female; D005494:Folic Acid Deficiency / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000378:metabolism / Q000473:pathology; D009960:Oropharynx / Q000473:pathology*; D013763:Tetrahydrofolates / Q000627:therapeutic use; D014805:Vitamin B 12 / Q000627:therapeutic use; D014806:Vitamin B 12 Deficiency / Q000150:complications* / Q000188:drug therapy
chemical_list: D013763:Tetrahydrofolates; D014805:Vitamin B 12; D002118:Calcium