A case of true red‐cell aplastic anæmia successfully treated with riboflavin

Abstract

APLASIA of the bone marrow may affect one or all of the cellular elements of the blood, and a proper understanding of aplastic ansmia must depend upon the results of bone-marrow examination. Heilmeyer and Begemann (1951, p. 856) have divided bone-marrow aplasia into four types :-( 1) pan-myelopathy, where all the cellular elements of the blood are affected and there is absence or reduction of the precursors of the megakaryocytes, leucocytes and erythrocytes ; (2) true red-cell aplasia, in which only the red-cell series is affected ; (3) white-cell aplasia ; and (4) thrombocyte aplasia, where megakaryocytes only are affected.The present paper concerns only true red-cell aplasia and records an example in an adult male African who was successfully treated with oral riboflavin.True red-cell aplasia is a very rare condition, but it has thrown much light on the factors concerned in the production of the various blood elements of the marrow. So far, only ten cases have been reported throughout the world (Kaznelson

Effect of flavin compounds on glutathione reductase activity: in vivo and in vitro studies

“…monly to be associated with GR deficiency (8), has been found to occur after the administration of galactoflavin (31), a riboflavin antagonist, and possibly in riboflavin deficiency (32). …”

Glutathione Reductase: Stimulation in Normal Subjects by Riboflavin Supplementation

“…However, many of the clinical states which have been associated with glutathione reductase deficiency may have as a common denominator abnormalities in riboflavin nutrition or riboflavin metabolism. In fact, dietary riboflavin deficiency (13), feeding of a riboflavin antagonist (14), and glutathione reductase deficiency (10) have been reported to be associated with hypoplastic anemia. Thus, a deficiency of one of the enzymes required for the synthesis of FAD from riboflavin, flavokinase or FAD pyrophosphorylase, might result in diminution of glutathione reductase activity of red cells as only one of a number of disturbances of activity of other flavin enzymes.…”

Biomarkers for the differentiation of anemia and their clinical usefulness

“…Riboflavin-responsive anemia was first described by Foy and Kondi4,5 about 60 years ago. This anemia is characterized by erythroid hypoplasia (small number of red cells produced) and reticulocytopenia (abnormal decrease in reticulocytes).…”

“…Limitations in the supply of several essential micronutrients can affect the production of new cells. Vitamins B 6 (pyridoxine)3 and B 2 (riboflavin)4,5 are needed for the synthesis of the protein globin and iron has to be incorporated into the final Hb molecule 6. Restrictions in the supply of these nutrients will produce small red cells (microcytosis) with low Hb concentration (hypochromia).…”