Megaloblastic Anaemia in Haemochromatosis.

IN 1877 Muller described a marked bronzed discoloration of the skin in some patients considered to have pernicious anaemia. This observation, confirmed later by Immerman (1879) is likely to be the first record of an association between a macrocytic type of anemia and haemochromatosis. Since that time French (1909), Roth (1915), Bork (1928), Cain (1940), Hotz (1944) and Harvier and Mallarme (1938) have all described similar findings. In reporting nine more cases with this association Koszewski (1952) suggested that the macrocytic megaloblastic anamia complicating haemochromatosis might not be true pernicious anamia, and more recently Granville and Dameshek (1958) have been able to obtain an excellent clinical and htematological response to therapy with folic acid in a subject with hemochromatosis and this type of anemia, as have Brunner and Frick (1963) who also studied two similar cases which responded specifically to folic acid therapy. Two more cases in which megaloblastic erythropoiesis has complicated haemochromatosis have been seen but in these two patients the anaemia has been refractory to both vitamin B12 and folic acid therapy.