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American Journal of Clinical Nutrition, Vol 14, 137-146, Copyright © 1964 by The American Society for Clinical Nutrition, Inc.

Pyridoxine-Responsive Anemia

Description of Three Patients with Megaloblastic Erythropoiesis

JOHN D. HINES M.D.1 and JOHN W. HARRIS M.D.1

1 From the Department of Medicine, Western Reserve University School of Medicine, Cleveland Metropolitan General Hospital, Cleveland, Ohio

Three elderly patients have been described with pyridoxine-responsive anemia; in each megaloblastic erythropoiesis was found. The clinical and laboratory manifestations are presented in detail, responses to therapy are analyzed, and comparisons are made with the findings obtained from studies of a total of sixty-one patients with pyridoxine-responsive anemia.

Concerning the pathophysiology of the disorder, it is concluded that a lesion exists at the cellular or subcellular level of the developing red cell such that supernormal amounts of pyridoxal phosphate are required. In some, the defect seems to be familial in nature.

Although pyridoxine-responsive anemia has usually been considered characterized by normoblastic erythropoiesis, hypochromic, microcytic adult erythrocytes and evidence of iron overload, the patients described have documented that other morphologic expressions occur in appreciable numbers and indicate that a clinical trial of pyridoxine should be assayed in obscure anemias accompanied by iron overload or familial involvement.






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Copyright © 1964 by The American Society for Nutrition