American Journal of Clinical Nutrition, Vol 21, 45-50, Copyright © 1968 by The American Society for Clinical Nutrition, Inc.

Hemolytic Anemia in Vitamin E Deficiency

¹ From the Department of Pediatrics, Hospital of the University of Pennsylvania and University of Pennsylvania School of Medicine, and the Department of Pit of Pediatrics and Clinical Research Center, Philadelphia General Hospital, Philadelphia, Pennsylvania

Vitamin E deficiency in the premature infant is associated with a hemolytic anemia. This anemia responds to tocopherol and the response is characterized by a rise in the hemoglobin and a fall in the reticulocyte count. Treatment of premature infants from birth wih supplemental vitamin E reduces the severity of anemia and prevents the marked reticulocytosis commonly observed in these infants of low birth weight.

Vitamin E deficiency in the rat results in the appearance of a mild compensated hemolytic process. This is accompanied by thrombocytosis. The erythrocytes demonstrate increased pentose phosphate pathway activity.

Tocopherol appears to be poorly absorbed from a low-fat diet in the premature infant. In infants with vitamin E deficiency there appears to be an increase in the creatine-to-creatinine ratio, lower serum proteins, and an increased excretion of methylmalonic acid in the absence of vitamin B₁₂ deficiency. The interrelationship of this potpourri of observations remains to be explained.