CHANGES IN THE ORAL MUCOSA IN IRON DEFICIENCY ANEMIA: FROM CLINICAL PHENOTYPE TO CYTOLOGICAL CHARACTERISTICS

Abstract

Iron deficiency anemia (IDA) is the most common nutritional deficiency disorder worldwide, and oral mucosal changes are often among its first clinical manifestations, often preceding hematological confirmation of the diagnosis. According to current data, the prevalence of oral mucosal lesions in IDA significantly exceeds that in the healthy population: the most common are burning of the oral mucosa (76.0%), varicose veins of the tongue (56.0%), xerostomia (49.3%), lichen planus (33.3%), and atrophic glossitis (26.7%). It is fundamental that even in the absence of visible clinical changes, patients with IDA exhibit measurable cytomorphological changes in the oral mucosal epithelium—increased cell area and diameter, nuclear area and diameter, and the nuclear-cytoplasmic ratio—which are similar to changes observed in precancerous conditions and radiation-induced lesions. Oral candidiasis in IDA is highly prevalent (81–85%), and resistance of candidal lesions to antifungal therapy should serve as a signal for the targeted exclusion of latent iron deficiency. This review systematizes the clinical phenotypes, cytological basis, and diagnostic significance of oral mucosal changes in IDA.