Responses to Physiologic Doses of Folic Acid in the Megaloblastic Anemias

摘要: Anemias associated with frank megaloblastic changes in the bone marrow are usually caused by a deficiency of either cyanocobalamin (vitamin B12) or folic acid. The clinical differentiation these deficiencies is almost entirely circumstantial and often difficult. presence certain when anemia combined system disease spinal cord probable secretion gastric intrinsic factor defective. latter association may be suspected established, order increasing certainty, demonstration (1) achlorhydria, (2) achylia, (3) failure to absorb oral radioactive unless this accompanied an preparation.1Occasionally diagnosis vitamin B12deficiency facilitated obtaining history total gastrectomy or, more rarely, long-standing vegetarianism.2Circumstantial evidence folic-acid less specific than that