Clinical, demographical and serolological profile of RAS in IDF soldiers

Background: Recurrent aphthous stomatitis (RAS) is a common morbidity with prevalence of 5% to 60% of the population. Most of the cases are idiopathic with no yet known etiology. Several possible factors contributing to RAS include stress and nutritional deficiencies. To our knowledge, no previous studies evaluated the influence military environment on RAS clinical manifestation. Objective: To characterize the clinical, demographical and serolological profile of RAS in Israel Defense Forces (IDF) soldiers. Methods: The study was approved by the IDF Helsinki committee. We retrospectively reviewed the charts of 49 IDF soldiers with RAS including full medical history and examination of each patient. All individuals underwent detailed questionnaire regarding demographical details (age, gender and ethnic group), details on their services in the army, stress, smoking habits, familial history of RAS, history of clinical presentation, course, and pervious therapies. Laboratory tests were performed to evaluate for an underlying cause of RAS including complete blood count with differential and platelet count, folate, vitamin B12, Ferritin, TSH, fasting Glucose, ALT, AST, total bilirubin, ALP, HSV Abs, CRP, ESR, RF, ANA, total IgE. Results: 83.33% of patients had non-caucasian origin. Positive family history was found in 48.94 % of patients. Significantly reduced frequency of tobacco smoking was found in the study group compared to the general population in Israel (18.8% vs. 36.9% respectively, P=0.036). Stress was reported by 51%. Average IgE levels was 213.55 IU/mL with 58.82% showing higher IgE levels compared to normal values. Moreover, IgE levels were correlated with young age (p=0.075). 7.32 % exhibit higher RF levels compared to normal values (>14IU/mL, p=0.006). Haematinic deficiency was found in 22.2%. Conclusion: IgE levels may serve as a novel diagnostic tool in patients with RAS