Vitamin E Responsive Megaloblastic Anemia in Infants with Protein-Calorie Malnutrition

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Abstract
Treatment with vitamin E has been shown to induce a favorable hematologic response in malnourished infants with macrocytic anemia. These changes include typical therapeutic-induced increase in reticulocytes, followed by erythropoiesis and abatement of macrocythemia and conversion of megaloblastic marrow to a normoblastic one. There was a restoration to normal of urinary creatine: creatinine ratio and an increase in previously low serum vitamin E levels. These findings suggest that this anemia may represent the counterpart in man of the anemia which occurs in tocopherol-deficient monkeys. They provide further support to the concept of closely interrelated metabolic functions of tocopherol, vitamin B12 and folic acid. It seems reasonable to believe that similar cases may be found elsewhere in regions in which protein-calorie malnutrition is common. The possibility of tocopherol deficiency may deserve further nutritional consideration than it has received in the past.

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