R. W. Vilter, M.D., F.A.C.P.
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Macrocytic megaloblastic anemias occur because of single or combined deficiencies of folic acid, vitamin B12, or ascorbic acid. Many other situations can result in mild or moderate macrocytosis, such as chronic liver disease, hemolytic anemia, refractory anemia (chronic bone marrow failure), but none of these produce a true megaloblastic bone marrow picture.
Chemical, microbiologic, and isotopic studies of patients with macrocytic megaloblastic anemia indicate that several deficiencies usually are responsible. Even the patient with a Shilling test typical of pernicious anemia, which is due to vitamin B12 deficiency, often is deficient in folic acid and has a very low ascorbic
Vilter RW. The Current Status of the Macrocytic Anemias.. Ann Intern Med. 1961;54:1052. doi: https://doi.org/10.7326/0003-4819-54-5-1052_3
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Published: Ann Intern Med. 1961;54(5):1052.
Hematology/Oncology, Red Cell Disorders.
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