Abstract

MACROCYTIC anamia, associated with a megaloblastic erythropoiesis, glossitis, weight loss, diarrhcra, and an absence of neurological symptoms or signs and of evidence of deficiency of vitamin B12 are usually accepted as the features of deficiency of folic acid or related pteroylglutamate compounds. Such an assumption is based on the clinical and hxematological remission induced by the administration of a synthetic compound, folic acid. The term ' folic acid' also stands for the family of conjugated pterins and pteridines having ' folic' biological activity (Hutner, Nathan and Baker, 1959). The clinical picture occurs in malnutrition, in certain diseases of the small intestine, such as cceliac disease, tropical sprue or jejunitis from various causes, and in pregnancy. Sometimes it follows treatment with anti-folic compounds, such as aminopterin, or with certain anti-convulsant drugs, such as primidone, phenobarbitone, epanutin or mysoline. Because of the variety of conditions in which deficiency of folic acid occurs, it is thought that it is the result of a poor intake, poor absorption, increased demand created by a disordered metabolism, or a combination of these factors.

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