Megaloblastic Anemia in an Adult Vegan

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Abstract
An adult vegan with megaloblastic anemia associated with vitamin B12 deficiency responsive to therapy consisting of 1 µg. per day of parenterally administered vitamin B12 is described. The patient had normal production of gastric intrinsic factor in addition to a normal absorptive capacity for vitamin B12 prior to therapy. The speculated sequence of events leading to the development of the megaloblastic anemia is presented along with a brief review of reports of nutritional vitamin B12 deficiency in the English literature.