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None have been independently replicated

The importance of these early signs is highlighted by S Boukssim from the Department of Oral Surgery, Faculty of Dentistry, Mohammed V University: "These oral changes may precede systemic symptoms of pernicious anaemia, underscoring their importance as early indicators of pernicious anaemia" [1]

Smith, I see this patient has DM and Neuropathy

The ephrin pathway plays a crucial role in immune function and inflammatory responses and proteomics studies further support evidence of chronic inflammation, perhaps chronic infection (Milivojevic et al., 2020) and immune dysregulation (Giloteaux et al., 2023), with additional links to coagulation abnormalities and chronic infection (Nunes et al., 2022)