THE USE OF FOLIC ACID IN THE TREATMENT OF ANEMIA OF RHEUMATOID ARTHRITIS—A PRELIMINARY REPORT
Authors: C A L STEPHENS, A L BORDEN
Journal: Annals of Internal Medicine (1947)

Article1 September 1947THE USE OF FOLIC ACID IN THE TREATMENT OF ANEMIA OF RHEUMATOID ARTHRITIS—A PRELIMINARY REPORTCHARLES A. L. STEPHENS JR., M.D., ALICE L. BORDEN, M.S., W. PAUL HOLBROOK, M.D., F.A.C.P., DONALD F. HILL, M.D., F.A.C.P.CHARLES A. L. STEPHENS JR., M.D.Search for more papers by this author, ALICE L. BORDEN, M.S.Search for more papers by this author, W. PAUL HOLBROOK, M.D., F.A.C.P.Search for more papers by this author, DONALD F. HILL, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-27-3-420 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptINTRODUCTIONIt is well established on sound evidence that rheumatoid arthritis is a systemic disease.1, 2, 3, 4 The most dramatic manifestation is usually a polyarthritis. However, associated fever, anorexia, weight loss, muscle atrophy, iritis, elevated sedimentation rate, and anemia, and the often dramatic relief with jaundice,5, 6 or pregnancy,7 prove conclusively its generalized nature.Of all the associated symptoms of rheumatoid arthritis almost consistently present is a hypochromic microcytic anemia of an appreciable degree.8, 9, 10Of 50 cases of rheumatoid arthritis chosen at random from our files the average initial hemoglobin before treatment was 11.04 grams, the average...Bibliography1. PEMBERTON R: A few simple recommendations to the general practitioner in his care for arthritics, Illinois Med. Jr., 1936, lxx, 479-483. Google Scholar2. PAINTER CF: Importance of early diagnosis and careful differentiation of types of chronic arthritis, New Eng. Jr. Med., 1933, ccviii, 447-450. CrossrefGoogle Scholar3. SMITH M: A study of 102 cases of atrophic arthritis. Introduction: Statistical data, New England Med. Jr., 1932, ccvi, 103-110; Constitutional defects, 1932, ccvi, 160-173; Etiologic factors, 1932, ccvi, 211-216. CrossrefGoogle Scholar4. MINOT GR: Chronic arthritis; remarks concerning prevention and treatment, Med. Clin. N. Am., 1932, xv, 797-804. Google Scholar5. HENCH PS: Effect of jaundice on chronic infectious (atrophic) arthritis and on primary fibrositis; further observations; attempts to reproduce the phenomenon, Arch. Int. Med., 1938, lxi, 450-480; 495-500. Google Scholar6. HENCH PS: The effect of spontaneous jaundice on rheumatoid (atrophic) arthritis; attempts to reproduce the phenomenon by various means including "`artificial jaundice" (induced hyperbilirubinemia), Brit. Med. Jr., 1938, ii, 394-398. Also in: Proc. of the International Congress on Rheumatism and Hydrology (London and Oxford) and the Bicentenary Congress on Chronic Rheumatism (Bath), March 25th to April 2nd, 1938, Headly Brothers, London, pp. 315-331. CrossrefGoogle Scholar7. HENCH PS: The ameliorating effect of pregnancy on chronic atrophic (infectious rheumatoid) arthritis, fibrositis, and intermittent hydrarthrosis, Proc. Staff Meet. Mayo Clin., 1938, xiii, 161-167. Google Scholar8. COLLINS DH: Observations on the anemia in chronic rheumatic disease, Lancet, 1935, ii, 548-550. CrossrefGoogle Scholar9. BREUER MJ: Chronic infectious arthritis, Nebraska State Med. Jr., 1938, xxiii, 361-365. Google Scholar10. GRAYBERNHARDGOWEN JWWGCH: Clinical pathology of rheumatoid arthritis, Am. Jr. Clin. Path., 1935, v, 489-503. CrossrefGoogle Scholar11. HENCH PS: Rheumatism reviews, Ann. Int. Med., 1940, xiii, 1655, 1837. Google Scholar12. HOLBROOK WP: The management of atrophic arthritis in relation to the different phases of the disease, Proc. Am. Assoc. for the Study and Control of Rheumatic Diseases, June 11, 1934. Google Scholar13. HOLBROOKHILL WPDF: Treatment of atrophic arthritis, Jr. Am. Med. Assoc., 1936, cvii, 34-38. CrossrefGoogle Scholar14. IRONS EE: Chronic arthritis, a generalized disease requiring individual treatment, Ann. Int. Med., 1936, ix, 1658-1663. Google Scholar15. HOLBROOK WP: Evaluation of therapy in chronic atrophic arthritis, Ann. Int. Med., 1933, vii, 457. Google Scholar16. DOUTHWAITE AH: The pharmacology of chronic rheumatism. In a survey of chronic rheumatic diseases, 1938, Oxford University Press, London, pp. 265-275. Google Scholar17. CECIL RL: Textbook of medicine, Fifth Edition, 1940, W. B. Saunders Co., Philadelphia and London, p. 1412. Google Scholar18. EdmundsGunn CWJA Cushny's Pharmacology and therapeutics, Eleventh Edition, 1938, Lea and Febiger, Philadelphia. Google Scholar19. HARTUNG EF: The treatment of chronic rheumatism, Trans. Am. Therapy Soc., 1938, xxxviii, 30-37. Google Scholar20. HADEN RL: Rheumatoid arthritis; etiology and treatment, Arch. Phys. Therapy, 1940, xxi, 671-677. Google Scholar21. FARRARRAYBURN GEFW: The blood in arthritis, Med. Clin. N. Am., 1940, xxiv, 1633-1645. CrossrefGoogle Scholar22. COPEMAN WS: Treatment of rheumatism in general practice, 1933, William Wood and Company, Baltimore, p. 215. Google Scholar23. SPIES TD: Effect of folic acid on persons with macrocytic anemia in relapse, Jr. Am. Med. Assoc., 1946, cxxx, 474. CrossrefGoogle Scholar24. SPIESVILTERKOCHCALDWELL TDCFMBMH: Oservations on the antianemic properties of synthetic folic acid, South. Med. Jr., 1945, xxxviii, 707. CrossrefGoogle Scholar25. VILTERSPIESKOCH CFTDMB: Further studies on folic acid in the treatment of macrocytic anemias, South. Med. Jr., 1945, xxxviii, 781. CrossrefGoogle Scholar26. MOOREBIERBAUMWELCHWRIGHT CVOSADLD: The activity of synthetic Lactobacillus casei factor ("folic acid") as an antipernicious anemia substance. I. Observations on 4 patients: 2 with Addisonian pernicious anemia, one with nontropical sprue and one with pernicious anemia of pregnancy, Jr. Lab. and Clin. Med., 1945, xxx, 1056. Google Scholar27. DARBYJONESJOHNSON WJEHC: The use of synthetic L. casei factor in the treatment of sprue, Science, 1946, ciii, 108. CrossrefGoogle Scholar28. SPIESLOPEZMENENDEZMINNICHKOCH TDGGJAVMB: The effect of folic acid on sprue, South. Med. Jr., 1946, xxxix, 30. CrossrefGoogle Scholar29. SPIESMILANESMENENDEZKOCHMINNICH TDFAMBV: Observations on the treatment of tropical sprue with folic acid, Jr. Lab. and Clin. Med., 1946, xxxi, 227. Google Scholar30. MILLSBRIGGSELVEHJEMHART RCGMCAEB: Lactobacillus casei factor in nutrition of the chick, Proc. Soc. Exper. Biol. and Med., 1942, xlix, 186. CrossrefGoogle Scholar31. WATSONSEBRELLMCKELVEYDAFTHAWKINSON CJWHJLFSV: Possible effectiveness of the L. casei factor (folic acid) concentrate on the refractory anemia and leukopenia following radiation therapy, Am. Jr. Med. Sci., 1945, ccx, 463. CrossrefGoogle Scholar32. HASKINSOSGOOD HDEE: Methods of estimating hemoglobin (Haskins-Sahli), Northwest Med., 1926, xxv, 500-503. Google Scholar33. PHILLIPSVAN SLYKEDOLEEMERSONHAMILTONARCHIBALDSTANLEYPLAZIN RADDVPKPBRMEGJ: The copper sulfate method for measuring specific gravities of whole blood and plasma, Monograph, New York, 1943; Bull. U. S. Army Med. Dept., 1943, lxxi, 66. Google Scholar34. OSGOODWILHELM EEMM: Reticulocytes, Jr. Lab. and Clin. Med., 1934, xix, 1120-1135. Google Scholar35. WESTERGREN A: Technic of red cell sedimentation reaction, Am. Rev. Tuberc., 1926, xiv, 94-101. Google Scholar36. OSGOOD EE: Modified Westergren method, laboratory diagnosis, Third Edition, The Blakiston Company, Philadelphia. Google Scholar37. OSGOODASHWORTH EECM: Atlas of hematology, J. W. Stacey, Inc., San Francisco. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: CHARLES A. L. STEPHENSJR., M.D.; ALICE L. BORDEN, M.S.; W. PAUL HOLBROOK, M.D., F.A.C.P.; DONALD F. HILL, M.D., F.A.C.P.*Received for publication October 5, 1946.The authors wish to acknowledge the generous assistance provided by Lederle Laboratories, Pearl River, New York in furnishing the necessary folic acid (Folvite) to make these studies possible. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byEstablishment of the Two SystemsRHEUMATISM AND ARTHRITIS REVIEW OF AMERICAN AND ENGLISH LITERATURE OF RECENT YEARS (TENTH RHEUMATISM REVIEW)* Part IIWILLIAM D. ROBINSON, M.D., F.A.C.P., EDWARD W. BOLAND, M.D., F.A.C.P., JOSEPH J. BUNIM, M.D., F.A.C.P., DARRELL C. CRAIN, M.D., F.A.C.P., EPHRAIM P. ENGLEMAN, M.D., F.A.C.P., WALLACE GRAHAM, M.D., F.R.C.P. (C), L. MAXWELL LOCKIE, M.D., F.A.C.P., MAX M. MONTGOMERY, M.D., F.A.C.P., CHARLES RAGAN, M.D., F.A.C.P., MARIAN W. ROPES, M.D., F.A.C.P., EDWARD F. ROSENBERG, M.D., F.A.C.P., CHARLEY J. SMYTH, M.D. 1 September 1947Volume 27, Issue 3Page: 420-432KeywordsAnemiaArthritisAtrophyFeversFolic acidHemoglobinMusclesRheumatoid arthritisRiversWeight loss ePublished: 1 December 2008 Issue Published: 1 September 1947 PDF downloadLoading ...