PEDIATRICS Vol. 32 No. 3 September 1963, pp. 376-383
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MEGALOBLASTIC ANEMIA ASSOCIATED WITH THE INGESTION OF PHENOBARBITAL AND PRIMIDONE

Report of a Case in a Six-year-old Child

Sigmund Benham Kahn M.D.1, Harold Lischner M.D.1, Lester Baker M.D.1, and William J. Williams M.D.1

1 Departments of Medicine and Pediatrics, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania

A new case of megaloblastic anemia which occurred in a 6-year-old girl receiving anticonvulsant therapy with primidone and phenobarbital is described. Low serum folic acid activity was found on admission. A prompt clinical and hematological remission occurred following the administration of 500 µg of folic acid per day, associated with a rise in serum folic acid activity to normal. Anticonvulsant therapy with phenobarbital was continued without supplemental folic acid, and 12 months following the correction of the anemia the serum folic acid level was again found to be low. This is further evidence for a relationship between folic acid deficiency and anticonvulsant drug therapy.

Submitted on January 23, 1963
Accepted on May 6, 1963