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Since the publications on megaloblastic anemia in infants in 1946 by Zuelzer and Ogden in the United States1 and by Amato in Italy2 in 1947, many cases have been added.3-9 This disease seems to be not uncommon in childhood, especially with malnutrition or kwashiorkor10,11; sporadic cases have been described previously by several authors.12-17Inasmuch as the diagnosis of megaloblastic anemia is based on the finding of megaloblasts in the bone marrow, our purpose was to determine the incidence of megaloblastic anemia in children admitted to our pediatric clinic during the last four years on whom bone marrow punctures were done. It was our purpose also to investigate the pathogenesis of megaloblastic anemia and the clinical symptoms in these children. MATERIALS AND METHODS During the years 1954 to 1957, a total of 1,200 bone marrow punctures were done on 800 children for the following indications:Hemoglobin

Erythroblastopenia or pure red cell aplasia was encountered in 186 children during an observation period of five years in the Pediatric Department in Djakarta, Indonesia. Twenty cases were of the acute type of erythroblastopenia, distinguished by a sudden drop of the hemoglobin content of the blood, reticulocytopenia, and disappearance of the erythroblasts in the bone marrow. Giant red cell precursors (giant reticular cells and proerythroblasts) appeared in the bone marrow. This condition lasted two days to two weeks. A subacute type of erythroblastopenia with a duration of two weeks to two months was found in 25 cases. The last group consisted of 141 cases of subchronic or chronic erythroblastopenia with a duration of more than two months. Malnutrition, infections and vitamin deficiencies were the main clinical findings in these children. The authors are of the opinion that erythroblastopenia is a maturation arrest of the erythropoietic system caused by protein deficiency and/or temporary deficiencies of one or more erythrocyte maturation or stimulating factors.