Folate levels and deoxyuridine suppression tests in protein-energy malnutrition

A group of 39 Nigerian infants and pre-school children with protein-energy malnutrition (PEM) have been studied. Red cell folate levels were within the range observed in 19 age-matched healthy Nigerian children. Serum vitamin B12 levels were either normal or raised. Deoxyuridine (dU) suppression tests were performed on the bone marrow cells of 30 of the patients and were abnormal in 13. It is proposed that the abnormal dU-suppressed values were not caused by vitamin B12 or folate deficiency and were probably a consequence of the protein deficiency. A few megaloblasts and several giant metamyelocytes were found in four of the cases of PEM; the remaining 35 cases had normoblastic erythropoiesis, sometimes with small to moderate numbers of giant metamyelocytes. All four marrow samples containing megaloblasts gave abnormal dU-suppressed values. However, in the marrows showing normoblastic erythropoiesis there was no correlation between the presence or absence of giant metamyelocytes and the dU-suppressed value.