Biochemical and Hematologic Lesions in Folic Acid Deficiency

Abstract

The earliest indication of developing folate deficiency in man occurs within 1 month of the onset of folate deprivation. It is a fall in the serum folate activity, as measured by microbiologic assay with L. casei. The next easily ascertainable sign occurs within the 2nd month: an increase in the average number of lobes of the nuclei of the neutrophilic polymorphonuclear leukocytes. After more than 3 months of folate deprivation, gross tissue depletion of folate becomes evident, as manifested by fall of L. casei-measurable erythrocyte and liver folate stores; rise in urinary excretion of formiminoglutamate (FIGLU), urocanate, formate, and aminoimidazolecarboxamide (AIC), and overt megaloblastic anemia.