Tongue disorders of hepatological patients

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Introduction: Oral mucosa often reflects general health problems since most systemic diseases have oral manifestations. Geographic tongue, also called erythema migrans linguae, is a condition characterised by recurring appearance and disappearance of irregular, smooth and erythematous areas, usually with a sharply-defined border at which the filiform papillae are lost. The aetiology of geographic tongue is currently unknown. Patients with hepatological diseases more frequently have defects in the metabolism of iron and carbohydrates than in patients without any liver disease. The aim of this study is to explore any possible risk factors for this tongue disease, in patients with hepatological conditions, by comparing them to patients with hepatological conditions but normal oral mucosa. Patients and methods: The study involved 175 patients with diverse liver disorders, attending regularly at Hepatology Department of Internal Medicine from August 2006 to October 2007. 69 males (mean age of 49.4 ± 13.2) and 106 females (mean age of 52.0 ± 14.3) were included in the study. The nature of the liver diseases, the existence of liver enzyme disorders, the presence of gastrointestinal diseases, diabetes, anaemia (any type), and iron metabolism disorders were registered as part of regular follow-up. Statistical processing included the frequencies of disorders. Hierarchical loglinear analysis was also performed to give an approximate model of risk factors for tongue disorders in these patients. Results: Based on statistics, abnormal liver function, anaemia, serum iron level, diabetes, and the concomitant existence of gastrointestinal diseases have a significant effect on the prevalence of geographic tongue. Serum iron level and diabetes seem to be the two main independent risk factors for tongue lesions. Discussion: Therapy of these tongue lesions must involve, if possible, the elimination of the previously mentioned risk factors.

Geographic tongue, disorders, liver, hepatological, erythema migrans, linguae, anaemia, anemia, diabetes, gastrointestinal iron