Value of Liver Extract (343) in Identifying and in Treating Certain Anemias of Infancy and of Childhood

Holt and Howland1in the last edition of their textbook, remarked: "The existence of primary anemia (pernicious anemia) in children is very doubtful. A number of cases have been reported but they do not, as a rule, bear critical analysis." In a review dated 1918, von Seht2concluded that the youngest authentic case is that of Kusunoki3whose patient was 6 years old at death. Although Kusunoki's patient presented a characteristic clinical picture of acute purpura hemorrhagica, the condition of the blood and the results of the postmortem examination appear to justify a diagnosis of pernicious anemia. Since von Seht's review, two other reports have been published concerning still younger children in whom the blood picture and necropsy observations were highly suggestive if not fully conclusive of primary anemia. One of these is reported by Vischer.4The patient was 3½ years of age at the onset