A Note on the Relationship of Pellagra to Pernicious Anemia

Abstract

Pellagra and pernicious anemia are now regarded as special types of deficiency diseases. They have in common such clinical manifestations as achylia gastrica, glossitis, peripheral neuritis, and central nervous system changes. Goldberger and his associates 1 , 2 believe that pellagra is caused solely by a diminished intake of some specific food substance (“vitamin G”). Rolph, 3 Turner, 4 and others have described cases developing secondary to lesions of the gastrointestinal tract. While it has likewise been suggested that in certain instances the lack of some substance in the diet may cause pernicious anemia, it usually follows the lack of the essential secretion (“intrinsic factor”) in the gastric juice which changes food into an anti-anemic substance. 5 A short time ago Spies and Payne 6 produced remissions in 2 patients with pernicious anemia, by giving an incubated mixture of beef muscle and achylic gastric juice from acute pellagrins. This observation indicated that the “intrinsic factor” was present in gastric secretions from pellagrins in an amount adequate to form the antianemic substance. They suggested in this study that the usual pellagrin apparently develops his disease as a result of inadequate food ingestion, whereas the usual pernicious anemia patient developed the anemia from the failure of his gastric juice to make an antianemic substance from food.

Since pernicious anemia and pellagra are both related to diet and its subsequent assimilation by the body, there have been recent attempts to recognize more specifically those substances in food which are important in the pathogenesis of the 2 diseases. Strauss and Castle 7 , 8 have found that the substance in food (“extrinsic factor”) concerned with the development of pernicious anemia is associated with so-called “vitamin G” which other workers have considered as the “antipellagric vitamin”.