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Atrophic glossitis is a non-specific finding, [16] and has a great many causes, usually related to iron-deficiency anemia, pernicious anemia, B vitamin complex deficiencies, [16] unrecognized and untreated celiac disease (which often presents without gastrointestinal symptoms), [17] [18] [19] or other factors such as xerostomia (dry mouth).
Pernicious anemia is the most common cause of clinically evident vitamin B 12 deficiency worldwide. [14] Pernicious anemia due to autoimmune problems occurs in about one per 1000 people in the US. Among those over the age of 60, about 2% have the condition. [8] It more commonly affects people of northern European descent. [2]
Main symptoms that may appear in anemia [20] The hand of a person with severe anemia (on the left, with ring) compared to one without (on the right). A person with anemia may not have any symptoms, depending on the underlying cause, and no symptoms may be noticed, as the anemia is initially mild, and then the symptoms become worse as the anemia worsens.
Angular cheilitis is thought to be a multifactorial disorder of infectious origin, [10] with many local and systemic predisposing factors. [11] The sores in angular cheilitis are often infected with fungi (yeasts), bacteria, or a combination thereof; [8] this may represent a secondary, opportunistic infection by these pathogens.
Pernicious anemia is the most common cause of vitamin B 12 deficiency anemia in adults, which results from malabsorption of vitamin B 12 due to a lack or loss of intrinsic factor. [2] [8] There are relatively few studies which have assessed the impact of haematological measures in response to B 12 supplementation.
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