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Blood, 1960, Vol. 16, No. 5, pp. 1546-1554.
© 1960 American Society of Hematology, Inc.

Megaloblastic Anemia Probably Caused by Defective Utilization of Folinic Acid

FARID I. HAURANI 1, GEORGE WANG 1, and L. M. TOCANTINS 1

1 Charlotte Drake Cardeza Foundation, Jefferson Medical College and Hospital, Philadelphia, Pa.

A 12 year old negro girl was studied who presented a picture of megaloblastic anemia refractory to physiologic doses of vitamin B-12 and to folic acid. However, remission could be induced and maintained by pharmacologic doses of vitamin B-12 (1000 µg. per week), by folinic acid or by a combination of vitamin C (or homocysteine) and folic acid. Folinic acid determinations and the clinical response to various metabolites indicated the existence of a metabolic defect in the utilization of folinic acid. The hereditary nature of this defect was suggested by the fact that two siblings might have had a similar condition.

Submitted on March 16, 1960
Accepted on July 15, 1960


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