A CASE OF HYPERCHROMIC MACROCYTIC ANEMIA REFRACTORY TO LIVER EXTRACT

This case of hyperchromic macrocytic anemia was fatal and is being reported here to illustrate some interesting features in differential diagnosis.

REPORT OF CASE  A woman aged 62 was in fairly good health except for hypertension until five months before admission to the hospital. At that time she noted unusual dyspnea on exertion, pallor and weakness, all of which increased rapidly within the following three months. Her physician found severe anemia with a high color index in the face of a normal gastric acidity, the figures being total acid 75 and free acid 58. X-ray examination of the gastrointestinal tract was negative. Since liver therapy and other measures did not yield a favorable response, she was referred to the hospital. Here one of us (D. G.) elicited the additional fact that she had received radiation therapy eight or ten times to the left breast for a bloody discharge from the