Vitamin E Responsive Megaloblastic Anemia in Infants with Protein-Calorie Malnutrition

Abstract

Treatment with vitamin E has been shown to induce a favorable hematologic response in malnourished infants with macrocytic anemia. These changes include typical therapeutic-induced increase in reticulocytes, followed by erythropoiesis and abatement of macrocythemia and conversion of megaloblastic marrow to a normoblastic one. There was a restoration to normal of urinary creatine: creatinine ratio and an increase in previously low serum vitamin E levels. These findings suggest that this anemia may represent the counterpart in man of the anemia which occurs in tocopherol-deficient monkeys. They provide further support to the concept of closely interrelated metabolic functions of tocopherol, vitamin B₁₂ and folic acid. It seems reasonable to believe that similar cases may be found elsewhere in regions in which protein-calorie malnutrition is common. The possibility of tocopherol deficiency may deserve further nutritional consideration than it has received in the past.