RELAPSES IN PERNICIOUS ANEMIA

Abstract

Before the introduction of liver therapy pernicious anemia was known as "a chronic malady with remarkable remissions."¹ The literature is studded with reports of unusually long remissions. Of Cabot's² 1,200 patients, 10 lived seven years or more between relapses, while 6 were considered as having recovered.³ Ten well authenticated cases have been reported with spontaneous remissions lasting ten years or more (table 1). Multiple relapses were not uncommon either, though few patients survived their third. According to Cabot, about 56 per cent had one spontaneous remission, 23 per cent had two, 12 per cent had three, 4 per cent had four and 4 per cent had five, each one lasting from three months to four years. This report is based on the observation of 54 patients with 88 individual self-induced relapses brought about by discontinuance of therapy, either immediately after release from the hospital or months or