Abstract
Fifty five cases of pyridoxine responsive anemia in literature including two of my own cases were analyzed and the variety of the blood pictures, clinical findings and responses to pyridoxine in these cases were compared with the prototype of Harris' case which was first reported in 1956. As a result of the analysis, it appears unlikely that the pathogenesis was a simple deficiency of pyridoxine in the usual sense, and it seems the basic factor is an insufficiency or defect of the pyridoxine dependent associated with unknown factors.
It is for this reason that pyridoxine dependent anemia syndrome, more fitting term than pyridoxine responsive anemia, should be chosen and might be divided into seven groups as follows; (1) Pyridoxine responsive hyperferremic state (in other words, prepyridoxine responsive anemia state, no hematological disorder except for hyperferremic state with effective pyridoxine). (2) Congenital pyridoxine responsive anemia (for cases in literature suspected). (3) Familiar pyridoxine responsive anemia (heredity may be proved). (4) Pyridoxine deficiency anemia (pyridoxine deficiency will be proved and associated with pyridoxine deficiency syndrome such as neurological or dermatological abnormality). (5) Pyridoxine responsive anemia (pyridoxine deficiency may not be proved, but pyridoxine is helpful). (6) Combined pyridoxine responsive anemia (although pyridoxine is effective, combined or single use with Vit. C, folic acid, liver extract, testosterone and tryptophane may also be favorable). (7) Drug induced pyridoxine responsive anemia (due to INH, desoxypyridoxine, cycloserine and penicillamine).
