The Differential Diagnosis of Sprue and Pernicious Anemia

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Ordinarily, the differential diagnosis between sprue and pernicious anemia should not present great difficulty to the clinician who is acquainted with both diseases, but of late we are hearing excellent men aver that they are identical or at least modalities of a common fundamental condition of nutritional character. These men, as a rule, are clinicians in temperate climates where sprue is not endemic and, with a clear knowledge of pernicious anemia, are impressed with the superficial clinical similarity and the almost identical hematology in certain cases of sprue which drift back to their Northern homes in or near a state of cachexia. When our best clinicians in the North can confuse pernicious anemia with tropical sprue, the justification therefore must be pretty strong. As a matter of fact, the case of sprue developing an anemia of pernicious type may be almost indistinguishable from that clinical picture we recognize as pernicious anemia.