Macrocytic hyperchromic anemia in infancy is infrequently observed. Faber1 and Bachman2 have reviewed 19 previously reported cases. Langmead and Doniach3 recorded an additional case. Macrocytic hyperchromic anemia in infancy usually is observed in previously healthy infants after an infection of the upper respiratory tract followed by a period of vomiting or diarrhea or both. The patients are noticeably malnourished and fail to gain weight in spite of changes in formulas and addition of various vitamins to the diet. Free hydrochloric acid is nearly always present in the gastric contents, although frequently decreased in amount. Administration of crude liver extract by mouth or injection has frequently been followed by reticulocytosis, rapid rise in the number of red blood cells and gain in weight. Anemia does not recur after it has once been relieved.
Because of the comparative rarity of this type of anemia, the case of a child
FOUTS PJ, GARBER E. NUTRITIONAL ANEMIA IN AN INFANT RESPONDING TO PURIFIED LIVER EXTRACT. Am J Dis Child. 1942;64(2):270–273. doi:10.1001/archpedi.1942.02010080064009