Relation of Cholesterol and Lecithin to Remission in Pernicious Anemia.

Abstract

It has been recognized that the cholesterol and lecithin content of the blood are low in severe relapses of pernicious anemia and that these constituents tend to increase with the improvement of the patient's health. Whether the increase of cholesterol and of lecithin bears any definite relationship to the remission of the anemia has not been determined.

Determinations of cholesterol and lecithin in the plasma of 25 cases of typical pernicious anemia have been made, usually every other day over a period of many weeks. Cholesterol was determined by Bloor's method 1 and the lecithin according to the method described by Whitehorn. 2 On admission 4 cases had less than 1.0 million red blood cells, 7 had between 1.0 million and 2.0 million, and the other 14 had over 2.0 million per cu. mm. Of the 4 cases with less than 1.0 million red blood cells per cu. mm., all showed low values for both cholesterol and lecithin; in some instances less than 50% of normal. Two of these 4 cases had a rapid remission, one died soon after entering the hospital, and the fourth is still under observation.

The first case entered the hospital with a red blood cell count of 950,000 per cu. mm. The plasma cholesterol was 93 mg., and the lecithin phosphorus 4.3 mg. per 100 cc. For 17 days the patient was fed a test preparation. During this time the red blood cells fell to 644,000 per cu. mm., the cholesterol fluctuated between 56 and 93 mg. per 100 cc., while the lecithin phosphorus varied between 4.3 to 5.7 mg. per 100 cc. The patient was then given another test preparation of the same cholesterol content. A remission promptly set in, and a typical response of the reticulocytes occurred, accompanied by a considerable rise in the cholesterol and lecithin values.