EVALUATION OF PARAMETERS OF FOLIC ACID AND VITAMIN B12 DEFICIENCY IN PATIENTS WITH IRON DEFICIENCY ANEMIA

Extract Neutrophil lobe averages and hypersegmentation, bone marrow examinations, serum folate and vitamin B12 levels, and formiminoglutamic acid (FIGLU) excretion studies were performed in a group of 55 infants and children with iron deficiency anemia, some with and some without thrombocytopenia. Increase lobe averages (> 3.71) and hypersegmentation were found in 13 and 32 patients, respectively. Twenty-five patients demonstrated some megaloblastic changes in their marrow. None had decreased serum levels of vitamin B12; two were considered folic acid deficient, based on serum folate assays (<3 ng/ml). Three had elevated urinary levels of FIGLU (> 6.6 μU;mol/h). In only five instances could a correlation be established between the morphologic and biochemical findings.The presence or absence of thrombocytopenia did not appear to be related to megaloblastic morphologic changes in the blood and bone marrow or to the number of bone marrow megakaryocytes. Speculation It is postulated that some of the changes in peripheral blood and bone marrow found in iron deficiency states are due to a relative lack of folate or vitamin B12 at the tissue level resulting from hyperplasia. The exact mechanism for the thrombocytopenia is not clear. © International Pediatrics Research Foundation, Inc. 1968. All Rights Reserved.