FOLATE DEFICIENCY IN CROHNS DISEASE - INCIDENCE PATHOGENESIS AND TREATMENT

In the present study of 64 patients with Crohn's disease < high incidence of folate deficiency was found among patients ir the active stage of the condition. Haematological changes due to the deficiency included macrocytosis and hypersegmented polymorphs in the peripheral blood and megaloblastic changed in the bone marrow. Biochemical changes included low serum and red cell folate levels and positive Figlu tests. Vitamin Bndeficiency was excluded as a cause of these changes in all but one patient. Folate deficiency appeared to be due to a combination oi factors—inadequate dietary intake, excess utilization, and malabsorption of the vitamin. There was a marked sube jective improvement and gain in weight in all seven folate-deficient patients given folic acid therapy and definite haematol logical improvement in the three with the most severe deficiency. Folate deficiency in three patients with active Crohn's disease remitted spontaneously after successful surgical therapy of the Crohn's disease itself. It is concluded that severe folate deficiency is a frequent complication of active Crohn's disease and that folic acid therapy may prove beneficial in a high nronortion of such natients. Because of the high frequency of B13 deficiency in Crohn's disease, however, it is always essential to exclude this before giving folic acid. Folate deficiency in Crohn's disease may be cured slowly without folic acid therapy, by successful treatment of the Crohn's disease itself. © 1968, British Medical Journal Publishing Group. All rights reserved.