Successful treatment of liver-refractory anemia with synthetic Lactobacillus casei factor.

By JAN WALDENSTR#{246}M, M.D. T HE TREATMENT of pernicious anemia that is refractory to liver has been one of the most difficult problems in hematology. In many of these cases the result of treatment with liver extracts is excellent for some time and everything seems well. Later the patient responds less and less to antianemic treatment and the final outcome is usually fatal. Before discussing the favorable results of treatment with folic acid in such conditions, it may seem appropriate to treat some questions of nomenclature briefly. For example, it is evident that the name “folic acid” is not a synonym for the synthetic lactobacillus casei factor. For the sake of brevity, however, it is used here in this meaning. In 1935 and 1936, Isrkls and Wilkinson introduced the expression achrestic anemia to characterize cases showing a pernicious anemia-like blood picture but having a normal gastric acidity, no disturbance of the gastrointestinal tract, no