Progressive Addisonian Pernicious Anemia, Successfully Treated with Intravenous Choline Chloride.

نویسندگان

  • F B Moosnick
  • E M Schleicher
  • W E Peterson
چکیده

Sudden failure of an occasional patient afflicted with Addison-Biermer's disease (Addisonian pernicious anemia) to respond to adequate amounts of purified liver extracts in the absence of factors known to interfere with a therapeutic response has been observed by us during the past few years in the Minneapolis General Hospital. The occurrence of a refractory state for no apparent reasons has also been noted by others (1 to 4). Because little is known about the chemical nature of the liver factor (anti-pernicious anemia factor) or the physiologic dose, including the development of a progressive anemic state under adequate amounts of purified liver extracts, we felt justified in publishing an observation which we believe may indicate one of the mechanisms responsible for a sudden refractory behavior of certain patients. We could demonstrate in a male afflicted with Addisonian pernicious anemia that fatty liver and fatty metamorphosis of the bone marrow organ were apparently factors in the development of a progressive anemic state. Without further administration of liver extract, the progressive anemic state was brought into remission by means of the administration of a 5 per cent solution of choline chloride (Merck), 20 ml. intravenously for 16 successive days. The doses were given at a rate of 1 ml. per minute. The first dose caused flushing and some nausea after 10 ml. were administered. No significant drop in blood pressure was observed. The successive doses were well tolerated.

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عنوان ژورنال:
  • The Journal of clinical investigation

دوره 24 3  شماره 

صفحات  -

تاریخ انتشار 1945