PEDIATRICS Vol. 81 No. 6 June 1988, pp. 875-876
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Megaloblastic Anemia Characterized by Microcytosis: Imerslund-Grasbeck Syndrome With Coexistent agr-Thalassemia

CAROLYN L. RUSSO MD1, PAUL E. HYMAN MD1, and RONALD S. OSEAS MD1

1 Department of Pediatrics, Harbor University of California, Los Angeles, Medical Center Los Angeles

Imerslund-Grasbeck syndrome is a hereditary autosomal recessive condition of selective vitamin B12 malabsorption in the terminal ileum, resulting in chronic megaloblastic anemia.1,2 The purpose of this report is to describe a child with coincident Imerslund-Grasbeck syndrome and agr-thalassemia, who also had a vitamin B12-sensitive microcytic anemia.

CASE REPORT

When R.S. was 15 months of age his mother reported that progressive anorexia and lethargy had developed. There was no history of chronic diarrhea, vomiting, frequent infections, or pica; there was no family history for blood dyscrasias.

R.S. was a black boy who weighed 8.3 kg (less than the fifth percentile); his length was 74 cm (less than the fifth percentile), and his head circumference was 45 cm (second percentile).

Submitted on April 13, 1987
Accepted on July 10, 1987