PERNICIOUS ANEMIA IN CHILDHOOD

IN A RECENT article¹a colleague and I reviewed the literature relating to pernicious anemia in childhood and reported the first authenticated case^1afrom America. In this postscript I wish to show the responses of the patient to folic acid. The patient, A. A., has been followed continuously since November 1940. Throughout she has shown gastric achlorhydria and can be maintained in a state of health only when she is continuously treated for anemia with liver extract or an equivalent. She has been observed through five relapses, some specifically induced by withdrawal of treatment. Erythropoiesis has shown consistently with each relapse an arrest of maturation at the megaloblastic level. She responds in a characteristic way to the administration of liver extract (chart 1). On Feb. 6, 1946, she received her last injection of liver extract²but continued until March 25, 1946, to receive orally 4 cc. of