Folate deficiency during intravenous hyperalimentation.

Two alcoholic patients were supported with hyperalimentation therapy during the management of complicated surgical problems. Folate deficiency was documented after ten and two weeks of intravenous feeding. One patient developed severe pancytopenia. Folic acid treatment resulted in hematologic recovery in both cases. Early development of folate deficiency in these patients seems to be related to multiple factors, viz., poor folate stores related to chronic alcoholism, poor dietary intake before and during the hospitalization, infection, prolonged gastric suction, and lack of folate in the intravenous hyperalimentation fluids. Rationale for the supplementation of folates in such patients is discussed.