The Relation of Sprue to Pernicious Anemia

With a Report on Blood Changes in 45 Cases of Sprue

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In the present paper are presented the considerations which have convinced the writer that pernicious anemia and sprue are two distinct disease entities, and that the former is not a final picture of the latter or vice-versa, as Christian (1) and others have suggested. On the basis of a detailed study of 45 cases of sprue in Porto Rico, the conclusion has been reached that in the average case the diagnosis is easily made by the general practitioner in routine examination. It is only occasionally, and this in the advanced stage of sprue,—the so-called sprue cachexia,—that the clinical picture bears such a resemblance to pernicious anemia as to readily lead to confusion. Even in these instances the writer is convinced that a thorough clinical and laboratory examination by the ordinary methods available in the average hospital will establish an absolute diagnosis in over 75 per cent of the cases.

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