Three cases of vitamin B12 deficiency anemias (megaloblastic anemias) are presented in this report.
The case 1 was a woman of 71 years old, who was diagnosed as pernicious anemia on October 1968. Her serum vitamin B12 level (L. leichimanii) was 50 pg/ml and serum folate level (L. casei) was 45 ng/ml. This high folate level returned normal after the injection of hydroxocobalamin. The case 2 was a man of 62 years old who had been resected his stomach 9 years before admission. His serum vitamin B12 level was 30 pg/ml on May 1969. The serum folate level was 50 ng/ml. After the injection of methylcobalamin, his serum folate level falled rapidly to subnormal level. The case 3 was a 55-year-old woman. Her serum vitamin B12 level on March 1969 was 40 pg/ml and serum folate level was 50 ng/ml. This case was not examined for the serum folate level after the treatment. Discussion is made about the pathogenesis of high serum folate level in pernicious anemia especially concerning about the methyltetrahydrofolate trap hypothesis of Herbert.
