Megaloblastic Anaemia in Congenital Spherocytosis

M}OICAL JOUTRNAL cythaemia vera who, after venesections, developed an anaemia resembling pernicious anaemia and who responded dramatically to liver therapy. Wellington and Whitcomb (1960), however, reported the case of a patient with polycythaemia vera who, after venesections, developed an anaemia resembling perni- cious anaemia and who responded dramatically to liver therapy. This patient died from pyelonephritis following prostatectomy. At necropsy normal red-blood-cell maturation was found in the bone marrow, as was myeloid metaplasia in the spleen. The case reported by Hinz (1957) showed cerebral haemorrhage and necrosis at necropsy, but otherwise the post-mortem findings were generally similar to those in the case we have described. Summary A case is described of a woman showing megalo- blastic anaemia, who developed features of poly- cythaemia vera after treatment with liver or vitamin B12' Anaemia recurred on discontinuation of treatment.