The Epithelial Cells in Megaloblastic Anaemias

Abstract

The earliest cytological abnormalities to be recognized in pernicious anaemia were, of course, those of the blood. Apart from the various changes seen in the mature red cells, circulating nucleated precursors showed sufficiently striking alterations for Ehrlich to give them the separate name of megaloblast (Ehrlich, 1880 The enlargement of the nuclei of the buccal cells can best be studied in smears of saliva, and one of us (M. M. B.) began to measure these cells in order to determine whether the changes are specific for megaloblastic anaemias or simply related to glossitis and atrophy of the tongue. The results (Boddington, 1959) showed that similar changes are indeed found in the saliva of patients with smooth tongues due to iron-deficiency and other causes, although not to the same degree as in certain cases of megaloblastic anaemia; the same changes were also sometimes found in patients with megaloblastic anaemia whose tongues were not smooth. Nuclear enlargement was not constantly found in megaloblastic anaemias, even in the presence of some lingual atrophy.

Symposium on Neurological Abnormalities Found in Association with Various Forms of Macrocytic Anæmia

“…In other areas with a rapid turnover of cells, nuclear maturation is at fault (Mallarme 1948). In patients with addisonian anemia, cells with abnormally large nuclei have been found in the stomach (Rubin & Massey 1953, Graham & Rheault 1954; in the mouth (Boen 1957, Farrant 1958; in the vagina (van Niekerk 1962); and very occasionally elsewhere (Boddington & Spriggs 1959). Identical findings have been reported in patients with other forms of megaloblastic anmmia (Gardner 1956, Boddington 1959.…”

Quantitative Exfoliative Cytology of Normal Oral Squames: An Age, Site and Sex-Related Survey

“…Previous studies on the effects of anaemia on oral squames are by no means conclusive. The majority of authors agree that B12 deficiency results in an increase in nuclear size which returns to normal following treatment therapy (Boen 1957, Nieburgs et al 1962, Boddington & Spriggs 1959, Boddington 1959. Finch (1971) detected no change in the nuclear size of buccal squames in patients on the antifoliate drug methotrexate.…”

Folate Deficiency in Humans

“…In patients with folate deficiency, morphologic changes essentially the same as those seen in the marrow have been demonstrated in the tongue and buccal mucosa (Boddington and Spriggs, 1959) and in the jejunum in association with coexisting sprue (Veeger et al, 1965). Jejunal biopsies were, normal, however, in experimental folate deficiency (Herbert, 1962a) and in six patients with megaloblastic anemia, four of whom were alcoholics (Winawer et al, 1965).…”