Iron Deficiency Anaemia — ORE Part 1 MCQ

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ModerateOral MedicineIron Deficiency AnaemiaORE Part 1

A 35-year-old woman with a history of coeliac disease presents with recurrent oral ulceration and angular cheilitis. Blood tests reveal a haemoglobin of 98 g/L. Which deficiency is most likely contributing to her oral symptoms?

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Correct answer: C — Iron

Iron deficiency anaemia is the correct answer. The clinical triad of recurrent oral ulceration, angular cheilitis, and anaemia (Hb 98 g/L) strongly suggests iron deficiency. Coeliac disease causes malabsorption in the small intestine, predisposing to iron deficiency. While coeliac disease can cause multiple micronutrient deficiencies, iron deficiency is particularly associated with the specific constellation of glossitis, angular cheilitis, and recurrent aphthous ulceration. B12 and folate deficiency can cause glossitis and oral ulceration, but angular cheilitis is classically attributed to iron deficiency. Vitamin D and C deficiencies do not typically present with this pattern of oral manifestations in coeliac disease.

Reference: Peer-reviewed literature: (1) Initial diagnosis of anemia from sore mouth and improved classification of anemias by MCV and RDW in 30 patients. PubMed 15583540 (2005). (2) State of knowledge of the relationship between celiac disease and oral pathology: A scoping review. PubMed 39864082 (2025). https://pubmed.ncbi.nlm.nih.gov/39864082/