For the past several years an increasing number of reports concerning the occurrence of megaloblastic anemia and folic acid deficiency in association with chronic hemolytic anemia have appeared in the literature. The comments regarding this combination have differed widely. Opinions have ranged from a common occurrence and a definite relationship in the pathogenesis of aplastic crises on the one hand to a rare occurrence and no definite relationship on the other hand. In addition, little mention has been made regarding its occurrence in children.
During a six-month period of investigation of folate levels in various hematological conditions, we had the opportunity to study serum folate levels, urinary formiminoglutamic acid excretion (FIGLU), and marrow aspirations in 24 patients with chronic hemolytic anemias. Although this was not a prospective study, we believe that the report of our findings aids in understanding some of the questions relative to folic acid deficiency in chronic