Pernicious Anaemia Oral Features — MFDS Part 1 MCQ
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Correct answer: E — A smooth, erythematous, depapillated tongue with recurrent oral ulceration
Pernicious anaemia causes vitamin B12 deficiency through impaired intrinsic-factor-dependent absorption. A characteristic oral manifestation is atrophic glossitis: the tongue becomes smooth, erythematous and depapillated and may be sore or burning. Recurrent oral ulceration or aphthous-like stomatitis may also occur. White reticular striae suggest oral lichen planus. Bilateral parotid enlargement with xerostomia is more suggestive of salivary-gland disease such as Sjögren syndrome. Gingival enlargement is associated with conditions such as leukaemia or medicines including phenytoin, ciclosporin and some calcium-channel blockers. Diffuse oral pigmentation raises alternative diagnoses, particularly primary adrenal insufficiency, rather than being a characteristic presentation of pernicious anaemia.
Reference: NHS. Vitamin B12 or folate deficiency anaemia: Symptoms. Last reviewed 20 February 2023. https://www.nhs.uk/conditions/vitamin-b12-or-folate-deficiency-anaemia/symptoms/