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March 15, 1947

FOLIC ACID IN PERNICIOUS ANEMIAFailure to Prevent Neurologic Relapse

JAMA. 1947;133(11):739-741. doi:10.1001/jama.1947.02880110005002

The ability of synthetic pteroylglutamic (folic) acid to induce hematologic remissions in patients with macrocytic anemia associated with megaloblastic hyperplasia of the bone marrow has been well established. A recent review by Berry and Spies1 covers the subject adequately.

While the results of treatment with folic acid appeared to be similar to or identical with those of treatment with purified extracts of liver, it was recognized2 that a considerable period of study would be necessary to ascertain whether folic acid would be as effective as extracts of liver in the maintenance of remission. In pernicious anemia it was also of importance to determine whether folic acid would cause arrest of neurologic lesions as effectively as do extracts of liver.

Recent reports3 have indicated that in some patients with pernicious anemia there develops decided progression of neurologic lesions while they are being maintained on folic acid. The following

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