Hepatoflavin and Pernicious Anemia

Abstract

The following reasons led to the idea that hepatoflavin might be related to the hematopoietic factor used in treating pernicious anemia. Liver and liver concentrates of therapeutic value are rich sources of flavin. Flavin appears to be one of the components of vitamin B₂, which has been regarded as concerned with the extrinsic factor of Castle. West and Howe 1 reported that the hematopoietic activity of their most potent liver concentrate was precipitated from alcoholic solution by Ba(OH)₂; we find that the flavin in liver extracts is similarly precipitated. It seemed desirable to test whether flavin might be effective in pernicious anemia therapy.

Incubation of liver with pig stomach, which appears to increase the hematopoietic activity, does not increase the flavin content.

Purified flavin prepared from liver by a process described elsewhere, has been administered to 5 patients. The material was given by intramuscular injection, in amounts (5 cc.) representing 500 gm. of fresh liver. The criteria of effect were the hemoglobin, erythrocyte, and reticulocyte response. The 5 patients studied in this manner gave uniformly negative results. Since no effect was noted it is not necessary to record the protocols. The following statement is representative. Five cc. of flavin solution were given on alternate days until a total of 25 cc. had been injected. No significant change in the blood picture was noted during this period. The patient was then given commercial liver concentrate, which was followed by the typical reticulocyte response, generally on the fourth day.