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Failure of Response to Massive Parenteral Doses of Cyanocobalamin

ZACHARIAS D. KOMNINOS, MD; WILLIAM F. MINOGUE, MD; JOAN SARVAJIC-DOTTOR, MD

Arch Intern Med. 1965;115(6):663-666.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

IN A CASE of hereditary spherocytosis, complicated by severe megaloblastic anemia, the patient failed to respond to massive doses of cyanocobalamin (vitamin B₁₂) given parenterally but did respond rapidly to minute oral doses of folic acid. These last observations cast some doubt upon the ability of cyanocobalamin to affect megaloblastic anemias due to folic acid deficiency.

Report of a Case

A 45-year-old Irish housewife was admitted to the psychiatric division of St. Vincent's Hospital on June 26, 1963, complaining of weakness, fatigue, anorexia, pain in the tongue, palpitations, dyspnea, and ankle edema, all of about three weeks' duration.

She was first seen in this hospital in March 1959, when the diagnosis of hereditary spherocytosis was made on the basis of splenomegaly, reticulocytosis (6.8%), spherocytosis of the red blood cells, normoblastic hyperplasia of the bone marrow, and increased hypotonic fragility (Fig 1). At that time the patient was not significantly . . . [Full Text PDF of this Article]

Author Affiliations
NEW YORK

From the Department of Medicine and the Hematology Service, St. Vincent's Hospital and Medical Center of the City of New York. Clinical Assistant in Medicine (Dr. Minogue); Former Senior Resident in Hematology (Dr. Sarvajic-Dottor). Director of Hematology, St. Vincent's Hospital, and Assistant Professor of Medicine, New York University School of Medicine (Dr. Komninos).

Footnotes
Received for publication Dec 15, 1964; accepted Jan 5, 1965.

Reprint requests to St. Vincent's Hospital, New York 10011 (Dr. Komninos).

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