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Clinical usefulness of urinary Figlu test in megaloblastic anaemias

, : Clinical usefulness of urinary Figlu test in megaloblastic anaemias. British Medical Journal 1(5332): 717-720

Simple electrophoresis of untreated urine in patients receiving a histidine load (15 g. of L-histidine monochloride) has been used to detect the excretion of abnormal amounts of formiminoglutamic acid (Figlu). A horizontal type, 1,000-volt electrophoresis instrument was used and a clearly recognizable spot of Figlu on the paper strip (a positive test) has been considered indicative of a deficiency in folic-acid metabolism. The patients studied were 50 cases of megaloblastic anemia or related conditions. In was found that all of five patients with dietary deficiency of folic acid, four of six patients with cirrhosis, and three of eight patients with a malabsorption syndrome had positive tests, which were easily reverted by the administration of folic acid. Eleven patients with pernicious anemia in remission had negative tests, but five out of eight patients with pernicious anemia in relapse had positive tests. Three of these five patients showed some resistance to folic-acid therapy in reversing the Figlu test to normal. Vitamin B12 alone reverted two of the patients to normal, but in another patient vitamin B12 failed to do this and she required injections of folic acid to achieve it. Other patients tested included cases of erythremic myelosis and leukemia with megaloblastic bone-marrow. It is considered that a positive Figlu test may result from dietary insufficiency of folic acid, malabsorption of folic acid, or from metabolic disturbances in the action of folic acid in the body, one important factor in this regard being vitamin B12 metabolism.


PMID: 13997267

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