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Julia Yu Fong Chang - One of the best experts on this subject based on the ideXlab platform.

  • antigastric parietal cell and antithyroid autoantibodies in patients with Desquamative Gingivitis
    Journal of Oral Pathology & Medicine, 2017
    Co-Authors: Julia Yu Fong Chang, Chunpin Chiang, Hsinming Chen
    Abstract:

    BACKGROUND Desquamative Gingivitis (DG) is principally associated with erosive oral lichen planus (EOLP), mucous membrane pemphigoid (MMP), and pemphigus vulgaris (PV). METHODS Serum autoantibodies including antigastric parietal cell antibody (GPCA), antithyroglobulin antibody (TGA), and antithyroid microsomal antibody (TMA) were measured in 500 patients with DG, 287 EOLP without DG (EOLP/DG- ) patients, and 100 healthy control subjects. RESULTS The 500 patients with DG were diagnosed as having EOLP in 455 (91%), PV in 40 (8%), and MMP in five (1%) patients. We found that 37.0%, 43.6%, and 42.6% of 500 patients with DG, 39.6%, 46.4%, and 45.1% of 455 EOLP with DG (EOLP/DG) patients, and 18.5%, 27.5%, and 30.3% of 287 EOLP/DG- patients had the presence of GPCA, TGA, and TMA in their sera, respectively. DG, EOLP/DG, and EOLP/DG- patients all had a significantly higher frequency of GPCA, TGA, or TMA positivity than healthy control subjects (all P-values < 0.001). Moreover, 455 EOLP/DG patients had a significantly higher frequency of GPCA, TGA, or TMA positivity than 287 EOLP/DG- patients (all P-values < 0.001). Of 210 TGA/TMA-positive patients with DG whose serum thyroid-stimulating hormone (TSH) levels were measured, 84.3%, 6.7%, and 9.0% patients had normal, lower, and higher serum TSH levels, respectively. CONCLUSION We conclude that 73.4% DG, 77.1% EOLP/DG, and 47.4% EOLP/DG- patients may have GPCA/TGA/TMA positivity in their sera. Because part of GPCA-positive patients may develop pernicious anemia, autoimmune atrophic gastritis, and gastric carcinoma, and part of TGA/TMA-positive patients may have thyroid dysfunction, these patients should be referred to medical department for further management.

  • hematinic deficiencies and anemia statuses in antigastric parietal cell antibody positive erosive oral lichen planus patients with Desquamative Gingivitis
    Journal of the Formosan Medical Association, 2016
    Co-Authors: Julia Yu Fong Chang, Yang Che Wu, Yuhsueh Wu, Chihhuang Tseng
    Abstract:

    Background/purpose Erosive oral lichen planus (EOLP) patients with Desquamative Gingivitis (DG) are sometimes encountered in our oral mucosal disease clinic. This study assessed hematinic deficiencies and anemia statuses in antigastric parietal cell antibody (GPCA)-positive EOLP patients with DG (GPCA+/DG+/EOLP patients). Methods The blood hemoglobin, iron, vitamin B12, folic acid, and homocysteine concentrations and serum GPCA levels in 92 GPCA+/DG+/EOLP patients and 184 age- and sex-matched healthy controls were measured and compared between the two groups. Results We found that 27 (29.3%), 16 (17.4%), and 27 (29.3%) of 92 GPCA+/DG+/EOLP patients had hemoglobin (men  12.1μM). GPCA+/DG+/EOLP patients had a significantly higher frequency of hemoglobin, iron, or vitamin B12 deficiency and an abnormally high blood homocysteine level than healthy control individuals (all p  Conclusion We conclude that GPCA+/DG+/EOLP patients may have vitamin B12 deficiency, iron deficiency, and an abnormally high blood homocysteine level. In addition to pernicious anemia, GPCA+/DG+/EOLP patients may sometimes have normocytic anemia or iron deficiency anemia.

  • Hematinic deficiencies and anemia statuses in antigastric parietal cell antibody-positive erosive oral lichen planus patients with Desquamative Gingivitis
    Elsevier, 2016
    Co-Authors: Julia Yu Fong Chang, Chihhuang Tseng, Andy Sun
    Abstract:

    Erosive oral lichen planus (EOLP) patients with Desquamative Gingivitis (DG) are sometimes encountered in our oral mucosal disease clinic. This study assessed hematinic deficiencies and anemia statuses in antigastric parietal cell antibody (GPCA)-positive EOLP patients with DG (GPCA+/DG+/EOLP patients). Methods: The blood hemoglobin, iron, vitamin B12, folic acid, and homocysteine concentrations and serum GPCA levels in 92 GPCA+/DG+/EOLP patients and 184 age- and sex-matched healthy controls were measured and compared between the two groups. Results: We found that 27 (29.3%), 16 (17.4%), and 27 (29.3%) of 92 GPCA+/DG+/EOLP patients had hemoglobin (men 

S Woo - One of the best experts on this subject based on the ideXlab platform.

  • oral mucous membrane pemphigoid and pemphigus vulgaris a retrospective two center cohort study
    Oral Diseases, 2017
    Co-Authors: Ahmed S Sulta, Alessandro Villa, A P Saavedra, Nathaniel S Treiste, S Woo
    Abstract:

    Objectives Few studies have compared oral mucous membrane pemphigoid (MMP) and pemphigus vulgaris (PV). Descriptive analysis of oral features, extent of extra-oral involvement, and management outcomes were performed. Subjects and Methods Patients with PV and MMP, the latter with exclusive oral involvement at first presentation, were included. Results There were 26 MMP (46%) and 31 PV (54%) patients. Desquamative Gingivitis was evident in 84% of MMP cases compared to 28% of PV cases (P < 0.05). Non-gingival lesions were noted in 6% of MMP cases compared to 55% of PV cases (P < 0.01). Management of MMP consisted of only topical corticosteroids in 88% of cases while 12% of cases required concomitant systemic therapy. All PV cases (100%) required systemic therapy. No patients with MMP developed scarring or ocular lesions, and one patient (4%) developed cutaneous lesions. Five PV cases (16%) had oral cavity involvement only with three (60%) developing pharyngeal involvement and two (40%) developing cutaneous lesions on follow-up. Conclusion Oral MMP presents primarily as Desquamative Gingivitis, infrequently involving extragingival sites, and is highly amenable to topical therapy, while PV is a systemic mucocutaneous disease with extensive non-gingival oral lesions that almost always requires systemic therapy.

Sookbin Woo - One of the best experts on this subject based on the ideXlab platform.

  • direct immunofluorescence is of limited utility in patients with low clinical suspicion for an oral autoimmune bullous disorder
    Oral Diseases, 2020
    Co-Authors: Scott C Bresler, Roxanne Bavarian, Scott R Granter, Sookbin Woo
    Abstract:

    OBJECTIVES Oral autoimmune bullous disorders show clinical overlap with diseases such as lichen planus and others that may cause Desquamative Gingivitis. As direct immunofluorescence is expensive, we sought to determine if routine histology alone would be sufficient to distinguish between oral autoimmune bullous disorders and mimics. METHODS We searched the records for patients with a suspected oral autoimmune bullous disorder who underwent biopsies for concurrent routine histologic evaluation and direct immunofluorescence and who had at least one follow-up visit. Cases were separated into high and low suspicion subgroups based on clinical findings. RESULTS Within 148 cases, the sensitivity of routine histology alone was 0.810, with a negative predictive value of 0.889. However, the specificity was 0.989 with a positive predictive value of 0.979. Of the high suspicion cases, 57 (47.1%) were found to be consistent with an oral autoimmune bullous disorder, with a total of 11 histologic false negatives. 8 cases, all in the high suspicion subgroup, showed indeterminate direct immunofluorescence results. There were no histologic false negatives or inconclusive direct immunofluorescence results in the low suspicion subgroup. CONCLUSIONS In patients with a low clinical suspicion for an oral autoimmune bullous disorder, it is reasonable and more cost-effective to evaluate the lesion with routine histology alone.

Lobat Tayebi - One of the best experts on this subject based on the ideXlab platform.

Chihhuang Tseng - One of the best experts on this subject based on the ideXlab platform.

  • hematinic deficiencies and anemia statuses in antigastric parietal cell antibody positive erosive oral lichen planus patients with Desquamative Gingivitis
    Journal of the Formosan Medical Association, 2016
    Co-Authors: Julia Yu Fong Chang, Yang Che Wu, Yuhsueh Wu, Chihhuang Tseng
    Abstract:

    Background/purpose Erosive oral lichen planus (EOLP) patients with Desquamative Gingivitis (DG) are sometimes encountered in our oral mucosal disease clinic. This study assessed hematinic deficiencies and anemia statuses in antigastric parietal cell antibody (GPCA)-positive EOLP patients with DG (GPCA+/DG+/EOLP patients). Methods The blood hemoglobin, iron, vitamin B12, folic acid, and homocysteine concentrations and serum GPCA levels in 92 GPCA+/DG+/EOLP patients and 184 age- and sex-matched healthy controls were measured and compared between the two groups. Results We found that 27 (29.3%), 16 (17.4%), and 27 (29.3%) of 92 GPCA+/DG+/EOLP patients had hemoglobin (men  12.1μM). GPCA+/DG+/EOLP patients had a significantly higher frequency of hemoglobin, iron, or vitamin B12 deficiency and an abnormally high blood homocysteine level than healthy control individuals (all p  Conclusion We conclude that GPCA+/DG+/EOLP patients may have vitamin B12 deficiency, iron deficiency, and an abnormally high blood homocysteine level. In addition to pernicious anemia, GPCA+/DG+/EOLP patients may sometimes have normocytic anemia or iron deficiency anemia.

  • Hematinic deficiencies and anemia statuses in antigastric parietal cell antibody-positive erosive oral lichen planus patients with Desquamative Gingivitis
    Elsevier, 2016
    Co-Authors: Julia Yu Fong Chang, Chihhuang Tseng, Andy Sun
    Abstract:

    Erosive oral lichen planus (EOLP) patients with Desquamative Gingivitis (DG) are sometimes encountered in our oral mucosal disease clinic. This study assessed hematinic deficiencies and anemia statuses in antigastric parietal cell antibody (GPCA)-positive EOLP patients with DG (GPCA+/DG+/EOLP patients). Methods: The blood hemoglobin, iron, vitamin B12, folic acid, and homocysteine concentrations and serum GPCA levels in 92 GPCA+/DG+/EOLP patients and 184 age- and sex-matched healthy controls were measured and compared between the two groups. Results: We found that 27 (29.3%), 16 (17.4%), and 27 (29.3%) of 92 GPCA+/DG+/EOLP patients had hemoglobin (men