Impaired Response to Iron Dextran Infusion Due to Latent Vitamin B 12 Deficiency without Achlorhydria

Abstract

A case of severe iron-deficiency anaemia as a result of intractable menorrhagia is described. Following treatment with an iron dextran infusion, an impaired haematological response occurred; this was shown to be the result of vitamin B₁₂ deficiency despite the presence of abundant free hydrochloric acid in the gastric juice. The severe anaemia (3.5 g. %) was corrected within 5 weeks by one iron dextran infusion and vitamin B₁₂ therapy prior to hysterectomy.