Abstract: Objective: To investigate the effects of low-dose and short-course oral prednisone on clinical outcome and immune parameters adjustment in the treatment of refractory recurrent aphthous ulcer (refractory RAU). Methods: Thirty-seven cases of patients with refractory RAU were administered with low-dose oral prednisone for one month. Ten mg/d prednisone for 20 days was then reduced to 7.5 mg/d for 5 days, and subsequently reduced to 5 mg/d for the last 5 days. Before and after treatment, blood routine, liver and kidney function, humoral and cellular immunity-related parameters in peripheral blood were tested. The clinical outcome and adverse reactions were evaluated after the treatment and two months later. Immune parameters change was observed after treatment. Results: The total efficiency was 100% after the treatment, and 91.4% at two months after the treatment. The levels of immunoglobulins and complements (IgG, IgA, IgM, IgE and C4) in peripheral blood significantly altered after the treatment (P<0.05). The percentages of immune cells (B and T lymphocytes and NK cells) in peripheral blood did not significantly change after the treatment. Conclusion: Low-dose and short-course oral prednisone therapy is effective in the treatment of refractory RAU with on adverse reaction, through prolonging intermission, reducing numbers and sizes of ulcers and decreasing pain index. The adjustment of humoral immunity could be one of the ways to treat refractory RAU.

Key words: Refractory, recurrent, aphthous, ulcer
Prednisone, Humoral, immunity, Cellular, immunity