American Journal of Clinical Nutrition, Vol 23, 1378-1384, Copyright © 1970 by The American Society for Clinical Nutrition, Inc.

Nutritional Macrocytic Anemia of Infancy and Childhood

¹ From the Haematology Laboratory, Department of Pathology and Department of Pediatrics, All-India Institute of Medical Sciences, New Delhi-16, India

Thirty-five children, from 6 months to 12 years of age, with nutritional macrocytic anemia have been studied. Of these, 29 did not have any clinical evidence of kwashiorkor or marasmic kwashiorkor, despite the fact that 34 of the 35 children had low serum albumin levels. Deficiency of vitamin B₁₂, manifested by a serum level below 80 pg/ml, was found in 19 children; of folic acid by a serum folate level below 3 ng/ml in 7 children; of iron by a serum iron below 40 ug/l00 ml in 15 children; and of protein by a serum albumin below 3 g/100 ml in 19 children. Megaloblastic marrows were found predominantly in those patients who had severe vitamin B₁₂ deficiency. An interesting relationship of coexistent iron and folic acid deficiency was found. Implications of iron deficiency on the folic acid status of the patient have been discussed. Delayed weaning, late introduction of solid foods in the diet, and excessive cooking of foods of poor nutritive value have been postulated to result in the general malnutrition of these children.

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