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Mucosa of the Small Intestine in Folate-Deficient Alcoholics

JOHN A. HERMOS, M.D.; WILLIAM H. ADAMS, M.D.; YONG K. LIU, M.D.; LOUIS W. SULLIVAN, M.D.; and JERRY S. TRIER, M.D.
[+] Article and Author Information

Presented in part 2 May 1971 at the National Meeting of the American Federation for Clinical Research, Atlantic City, N.J. (38).

Supported in part by grants AM-14420, AM-05005, AM-11329, and MH-14487 and by General Clinical Research Center Grant RR-00533 from the National Institutes of Health, Bethesda, Md. Dr. Trier and Dr. Sullivan are recipients of research career development awards AM-47257 and AM-14310 from the National Institutes of Health.

▸Requests for reprints should be addressed to Jerry S. Trier, M.D., Boston University School of Medicine, 80 E. Concord St., Boston, Mass. 02118.


Boston, Massachusetts


Ann Intern Med. 1972;76(6):957-965. doi:10.7326/0003-4819-76-6-957
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Peroral mucosal biopsy specimens from the duodenojejunal junction were obtained from alcoholics with marrow megaloblastosis caused by folate deficiency. Three patients with severe megaloblastosis had striking histological lesions of the intestinal mucosa that included decreased mitoses in the crypts, enlarged crypt and villous epithelial cells, increased cellularity of the lamina propria, and, in two of three patients, marked shortening of villi. Quantitation of mitoses, epithelial surface length, and epithelial-cell nuclear size confirmed the histologic observation. Five of eight patients with mild megaloblastosis had similar but less severe intestinal mucosal lesions. Six patients with intestinal lesions, who were rebiopsied after folate replacement therapy, showed reversion of the intestinal lesion to normal. Administration of large quantities of alcohol to two alcoholic volunteers induced histologic changes in the intestinal mucosa only when folate deficiency developed.

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