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March 1946

MEGALOBLASTIC ANEMIA IN INFANCY: A Common Syndrome Responding Specifically to Folic Acid Therapy

Am J Dis Child. 1946;71(3):211-243. doi:10.1001/archpedi.1946.02020260002001

THIS report, based on a detailed study of 25 patients,1 deals with a macrocytic anemia of common occurrence in infancy which hitherto has eluded a clear definition and has often escaped recognition altogether. The nature of this condition, which, for reasons stated later, we shall call megaloblastic anemia, has remained obscure and its diagnosis uncertain because the pathogenic mechanism has been studied by inadequate methods, unreliable hematologic criteria have been used, a uniform clinical picture is lacking and the response to therapeutic agents such as liver extract, therefore, has seemed inconsistent and unpredictable.

We shall endeavor to define this condition as a pathogenetic entity rather than as a disease of uniform causation. Like several other types of anemia, it represents a syndrome which can be induced by a variety of causative factors but is produced always by the same mechanism and reflects a specific disturbance in the physiology of