Megaloblastic Anemia Associated with Anatomic Lesions in the Small Intestine

This paper describes the development of anemia in six patients with strictures and anastomoses in the small intestine. The marrow proved to be megaloblastic in three instances, and megaloblastic change is presumed in the other three because of the clinical and laboratory findings, and the characteristic hemopoietic response to liver therapy. Responses to crude and refined liver extracts and vitamin B₁₂ compared unfavorably with those to be expected in Addisonian pernicious anemia; they were similar to the poorer responses often observed in megaloblastic anemia associated with idiopathic steatorrhea. The relationship of the intestinal lesion to the development of megaloblastic anemia is briefly discussed.