Pink staining of pernicious anemia megaloblasts by alizarin red S.

Abstract

The anthraquinone dye alizarin red S produced pink staining of the cytoplasm of proerythroblasts and megaloblasts in 8 patients with untreated pernicious anemia. This pink staining was not observed in erthyroid precursors from severely folatedeficient individuals, or from a variety of other types of anemic or normal controls. In the two instances of pernicious anemia where post-B12-treatment marrow samples were obtained, the pink staining was not found. In-vitro test-tube experiments with a wide variety of biologic substances showed that several intermediates in the Krebs carboxylic acid cycle, pentose-phosphate shunt pathway, NADPH, and methylmalonyl CoA produced pink to rose-colored solutions with alizarin. Although it was not possible to delineate the exact substance(s) responsible for the pink cytoplasmic staining, the marked elevations of cellular methylmalonyl CoA known to occur in B12 deficiency suggest that this substance may play an important role in the staining reaction.