SPECIFIC NATURE OF THE Duo - DENAL AND PROXIMAL JEJUNAL LESION IN

S OF SPECIAL INTEREST STUDIES OF CELIAC DISEASE. I. THE APPARENT IDENTICAL AND SPECIFIC NATURE OF THE DuoDENAL AND PROXIMAL JEJUNAL LESION IN CuilAc DISEASE AND IDIOPATHIC SPRUE. Cyrus E. Rubin, Lloyd L. Brandborg, Patricia C. Phelps and Hawley C. Taylor, Jr. From the Department of Medicine, University of Washington, Seattle, Washington. Gastroenterology 38:28, 1960. Histologically, the duodenal and proximal jejunal lesions of celiac disease and idiopathic sprue ( nontropical sprue, idiopathic steatorrhea ) are identical. The ileal mucosa may be normal. This important study bears on many questions, including: ( 1 ) Does the localization of the pathology suggest that folic acid is absorbed in the proximal intestine? ( 2 ) Since the ileum may be normal, and vitamin B19 is probably absorbed from the ileum, what is the mechanism of the poor B19 absorption of many patients with idiopathic steatorrhea? Can it be partly due to calcium lack (R. Gr#{228}sbeck,I. Kantero, and M. Siurala. Lancet 1:234, 1959)? Is it mainly due to diarrhea (F. D. Rosenthal, H. T. Swan, and G. R. Tudhope. Gastroenterology 37:282, 1959 )?-V. H. F0LIC-ACIn DEFICIENCY IN PREGNANCY. THE PATHOGENESIS OF MEGALOBLASTIC ANAEMIA OF PREGNANCY. I. Chanarin, B. M. MacGibbon, 1V. J. O’Sullivan and D. L. Mollin. From the Postgraduate Medical School of London, England. Lancet 2:634, 1959. Folic acid clearance tests were performed on 30 healthy nonpregnant women of child-bearing age, 250 pregnant women without anemia, 11 patients with normal twin pregnancy 34 to 39 weeks pregnant, and 1 1 patients with untreated megaloblastic anemia of pregnancy. Injected folic acid was cleared more rapidly from the plasma in pregnant than in nonpregnant women. The difference was already significant before the twelfth week of pregnancy, and the rate of clearance increased progressively from the twelfth to the thirtysixth week. At full term, and after the expected date of delivery, clearance was significantly slower than in subjects 37 to 40 weeks pregnant, though still more rapid than in early pregnancy. There was good correlation between the incidence of abnormal clearance tests at various stages of pregnancy and the rate of growth of the fetus and uterus. Folic acid clearance was more rapid in twin pregnancy than in single pregnancy and was most rapid in the group with megaloblastic anemia. Folic acid absorption tests were carried out on 90 healthy subjects of both sexes, 45 women between 20 and 40 weeks pregnant and 10 women with treated megaloblastic anemia of pregnancy. Absorption was significantly lower in the pregnant subjects than in the normal controls, and significantly lower in those with megaloblastic anemia than in normal pregnancy. It is concluded that the increased rate of clearance in pregnancy is due to folic acid deficiency. This is probably For personal use only. on October 3, 2017. by guest www.bloodjournal.org From