Department o Haematology, Postgraduate Medical School (fLondon$ f MEGALOBLASTIC is nearly always due to deficiency of folic acid, vitamin B12, or both. anaemia It is now accepted that folic acid deficiency leads directly to megaloblastic anaemia, but it is uncertain whether the megaloblastic anaemia associated with B12 deficiency is drrectly the result of this deficiency, or partly the result of secondary interference with the metabolism of folic acid. A number of observations suggest that the metabolism of folic acid may be abnormal in pernicious anaemia. The megaloblastic anaemia in this condition can be relieved, at least temporarily, by treatment with large doses of folic acid (5-10 mg. daily), whereas small doses (200-400 1 8 daily) are relatively ineffective (Marshall andJandl, 1960; Chosy, Clatanoff 1. and S c U g , 1962; Hansen and Weinfeld, 1962; Mollin and Waters, unpublished observations). This is characteristic of a âmass-actionâ effect, the excessive doses of folic acid producing a response despite the relative deficiency of B12 (Vilter, Horrigan, Mueller, Jarrold, Vilter, Hawkins and Seaman, 1950). A number of indirect methods have produced further evidence of abnormal folic acid metabolism in pernicious anaemia. The tissue uptake of a parenteral dose of folic acid
British Journal of Haematology – Wiley
Published: Jul 1, 1963
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