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Nisaa, Ihda R.
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Dentistry Health Professions

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Hypercobalaminemia in recalcitrant oral ulcers: A case report and literature review Nisaa, Ihda R.; Putri, Andi AM.; Marlina, Erni; Usman, Nur A.
Journal of Case Reports in Dental Medicine Vol 6, No 3 (2024)
Publisher : Hasanuddin University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20956/jcrdm.v6i3.245

Abstract

Objective: This article aims to report an interesting rare case of recurrent oral ulceration with a high level of cobalamin.Case report: A 44-year-old female came to dental clinic with chief complaint of recalcitrant oral ulceration since half a year ago. Patients basically had history of periodic oral ulcer for quite long time with short occurrence and only one or two ulcer in one period. However, the ulcer become alarming after she was hospitalized due to extreme fatigue. Patients subsequently instructed for routine blood along with cobalamin and IgE total examination. The test came back with highly decreased level of red blood index indicates that the patients on severe anemic condition. Unexpectedly, the levels of cobalamin in blood increased by 70% from the referral score. Patients urgently refer for hospitalization to recover her Hb level. After blood transfusion, patients discharged from the hospital but under hematologic observation for the exact etiology of her anemia, including the high cobalamin level. After two months observation, patients Hb gained normal level, however the vitamin B12 level remain. Patients reported decreased in number of ulcers.Conclusion:  It is worthy to always check on cobalamin level for patients with recurrent oral ulcers since lower level can directly causing it or the high level can lead to some life-threatening diseases which can also trigger the recalcitrant oral ulcers.
Hypercobalaminemia in recalcitrant oral ulcers: A case report and literature review Marlina, Erni; Putri, Andi AM.; Nisaa, Ihda R.
Journal of Case Reports in Dental Medicine Vol 5, No 1 (2023)
Publisher : Hasanuddin University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20956/jcrdm.v5i1.215

Abstract

Objective: Measuring levels of cobalamin (vitamin B12) in blood is frequently utilized to diagnosis deficiency in patients with recurrent oral ulceration. This article aims to report an interesting rare case of recurrent oral ulceration with a high level of cobalamin.Methods: a 44-year-old female came to dental clinic with chief complaint of recalcitrant oral ulceration since half a year ago. Patients basically had history of periodic oral ulcer for quite long time with short occurrence and only one or two ulcer in one period. However, the ulcer become alarming after she was hospitalized due to extreme fatigue. Patients subsequently instructed for routine blood along with cobalamin and IgE total examination.Results: The test came back with highly decreased level of red blood index indicates that the patients on severe anemic condition. Unexpectedly, the levels of cobalamin in blood increased by 70% from the referral score. Patients urgently refer for hospitalization to recover her Hb level. After blood transfusion, patients discharged from the hospital but under hematologic observation for the exact etiology of her anemia, including the high cobalamin level. After two months observation, patients Hb gained normal level, however the vitamin B12 level remain. Patients reported decreased in number of ulcers.Conclusion:  It is worthy to always check on cobalamin level for patients with recurrent oral ulcers since lower level can directly causing it or the high level can lead to some life-threatening diseases which can also trigger the recalcitrant oral ulcers.
Early detection, better prognosis in oral squamous cell carcinoma: A case report Nisaa, Ihda R.; Usman, Nur A.; Putri, Andi AM.; Marlina, Erni; Israyani, Israyani; Yusran, Ali
Journal of Case Reports in Dental Medicine Vol 7, No 3 (2025)
Publisher : Hasanuddin University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20956/jcrdm.v7i3.253

Abstract

Introduction: Misdiagnosed oral lesions can lead to delayed diagnosis and progression to malignancy, significantly impacting patient outcomes. Early detection of oral squamous cell carcinoma (OSCC) remains a significant challenge in clinical practice, particularly in cases with atypical presentation. We aim to highlight the importance of vigilance and early detection in improving prognose for patients with OSCC.Case Report: This case report discusses good progression of OSCC treatment in 43-year-old male who presented with a persistent ulcer on the ventrolateral tongue, initially attributed to trauma and misdiagnosed as a traumatic ulcer. Over nine months, the lesion progressively enlarged, with associated pain and induration, despite symptomatic treatment. The patient had a history of systemic conditions, along with previous tobacco use, which are recognized as risk factors for OSCC. Histopathological examination revealed keratinizing squamous cell carcinoma. Patient then treated with chemotherapy and showed significant progression on his tongue.Discussion: Early recognition of warning signs, such as non-healing ulcers with indurated borders, could have facilitated timely diagnosis and intervention. This case emphasizes the critical role of clinicians in identifying high-risk lesions, particularly in patients with systemic comorbidities or lifestyle-related risk factors. Regular oral health examinations, prompt biopsies, and multidisciplinary approaches are essential in reducing delays in diagnosing potentially malignant oral conditions.Conclusion: Clinicians must prioritize early evaluation and adopt a proactive approach in managing suspicious oral lesions to reduce the burden of advanced malignancies in oral health.
A rare case of recurrent aphthous ulcer associated with calcium channel blocker Ishak, Andi AQM.; Marlina, Erni; Usman, Nur A.; Putri, Andi AM.; Israyani, Israyani; Yusran, Ali; Nisaa, Ihda R.
Journal of Case Reports in Dental Medicine Vol 7, No 3 (2025)
Publisher : Hasanuddin University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20956/jcrdm.v7i3.251

Abstract

Introduction: The most commonly used hypertension medications are calcium channel blockers (CCB). Their oral impact is well recognized for gingival enlargement, yet is very limited to another oral manifestations. Here, we reported a rare case of recurrent aphthous ulcer in a patient under CCB medication.Case Report: A 59-year-old male patient came to Hasanuddin University Dental Hospital with a chief complaint of recalcitrant ulcers on his mouth three weeks ago, which started to occur continuously for a year after the regular consumption of amlodipine. Intraoral examination demonstrated painful solitary white ulcer on the right ventral of the tongue and on the left buccal mucosa. The working diagnosis of recurrent aphthous ulcer et causa CCB was made. Management includes dexamethasone gargle, triamcinolone acetonide gel, and chlorhexidine gluconate, which improved significantly. The patient was suggested to do a consultation with his internist regarding drug substitution.Discussion: The incidence of oral ulcers induced by CCB is predicted to be related to immunological mechanisms. Any drug component triggers an exaggerated immune reaction directed at the surface of the epithelium, resulting in ulcer. The potential for such response depends on the drug's immunogenicity, exposure frequency, and administration route.Conclusion: Practitioners should consider the possibility of oral ulceration triggered by a specific drug, especially if any therapy does not exhibit improvement. Moreover, dental literature must explore the association between CCB and oral ulcers more since this issue has limited explanations.
Co-Authors Ali Yusran, Ali Erni Marlina, Erni Ishak, Andi AQM. Israyani, Israyani Putri, Andi AM. Usman, Nur A.