Study of total stimulated saliva flow and hyperpigmentation in the oral mucosa of patients diagnosed with hereditary hemochromatosis. Series of 25 cases

OBJECTIVE To study lesions in the oral cavity of patients with hereditary hemochromatosis and determine their association with iron overload. STUDY DESIGN We took a clinical history, examined the pigmentation of the oral mucosa, and measured total stimulated saliva production. We correlated our results with epidemiological, phenotypic, and genotypic findings. Patients with associated diseases or drug therapy causing xerostomia were excluded. RESULTS We evaluated 25 patients (20 men, mean age 52 years) over a period of 6 months. No patient complained of xerostomia and pigmentation was not detected in the oral mucosa. The total stimulated salivary flow was reduced in 9 patients who had an average ferritin level of 796.5 µg/l. The decline in total stimulated salivary flow was significantly correlated with ferritin levels (p=0.002). Patients with ferritin levels within the normal range also had normal stimulated salivary flow. CONCLUSIONS We found no pigmented lesions in the oral mucosa; however, we did observe a decrease in total stimulated salivary flow that correlated with ferritin levels. Therefore, hyposialia caused by functional impairment of the salivary glands may be an early marker of iron deposition.