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January 18, 1947


Author Affiliations

St. Louis

From the Department of Internal Medicine, St. Louis University School of Medicine, and the Medical Service of the St. Mary's Group of Hospitals.

JAMA. 1947;133(3):178-179. doi:10.1001/jama.1947.62880030005007

One of the difficulties encountered in the treatment of macrocytic anemias with liver extract has been the development in occasional patients of allergic reactions to the liver extracts employed. Schwartz and Legere1 in a recent article suggested that such allergic reactions may be avoided by changing the "brand" or type of liver extract, by reducing the dose of liver extract, by desensitizing with liver extract or by utilizing a histamine-protein complex as an antigen to produce histamine antibodies. The successful use of folic acid in the treatment of macrocytic anemias2 suggests the possible value of this material in avoiding the effects of allergy to liver extract.

We have recently observed a patient suffering from addisonian pernicious anemia whose course was complicated by the presence of allergy to liver extract administered by parenteral injection. The sensitivity appeared to be organ-specific rather than species-specific since both hog liver and beef

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