What is the role of lab studies in the workup of recurrent aphthous stomatitis (RAS)?

Updated: May 11, 2020
  • Author: Jaisri R Thoppay, DDS, MBA, MS; Chief Editor: Arlen D Meyers, MD, MBA  more...
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  • Systemic disorders should particularly be suspected in the presence of features that may suggest a systemic background.

  • Diagnosis of recurrent aphthous stomatitis (RAS) is based on history and clinical features. No specific tests are available; however, to exclude systemic disorders discussed above, the following tests may be helpful:

    • Complete blood cell count

    • Hemoglobin test

    • White blood cell count with differential

    • Red blood cell indices

    • Iron studies (usually an assay of serum ferritin levels)

    • Red blood cell folate assay

    • Serum vitamin B-12 measurements

    • Serum antiendomysium antibody and transglutaminase assay (positive in celiac disease)

  • Rarely, biopsy may be indicated in cases in which a different diagnosis is suspected. Occasionally, for example, pemphigus may mimic RAS. Occasional RAS can mimic a neoplasm, necrotizing sialometaplasia, or TUGSE (traumatic ulcerative granuloma with stromal eosinophilia).

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