179 Vol. 8, March-April 1960 Hematologic Aspects of Sprue

syndronie has stimulated clinical investi-gation in the evaluation of hematinics for its therapy. In some respects, sprue has been considered a hematologic disorder. The re-sultant immediate treatment of the anemia has in many instances allowed the patient to re-sume activity and employment. In the Caribbean area, the presence of macro-cytic anemia with megaloblastic bone marrow has been necessary to authenticate a diagnosis of ru ’ Such criteria, however, have caused confusion in the comparison of problems of malabsorption in various other areas of the world. British workers in India, dealing primarily with military personnel, have not observed a large incidence of megaloblastic anemia.2 This difference has resulted in speculation that the sprue syndrome observed in the Caribbean area is actually an advanced form of nutritional anemia. Although two types of sprue may be inferred from the pres-ence or type of anemia, in reality such differ-ences reflect: (1) the duration of the disorder, and (2) the predisposition for onset of anemia because of previous nutritional deficiencies. The proposed classification of Stefanini3 can be used with profit to separate the hematologic complications (Table I). CLASSIFICATION Stage I (Early Phase) : The early manifesta