A patient is reported with pyridoxine responsive anemia superimposed upon a chronic hypochromic anemia with excess iron storage. A specific response to pyridoxine was demonstrated on several occasions with restoration of the blood picture to its original state. Dietary estimates of vitamin B6 intake demonstrated an increased requirement for the vitamin, approximately 2.5 mg. per day being required for hematologic remission. Splenectomy was followed by high circulating siderocyte levels and severe thromboembolic problems. The possible mechanisms for the development of pyridoxine responsive anemia are discussed briefly.

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