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Megaloblastic Anemia

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Leenah O

on 15 December 2013

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Transcript of Megaloblastic Anemia

Megaloplastic Anemia Definition Main causes: B12 (Cobalamin) defieciency Megaloblastic anemia
diagnosis Megaloblastic anemia is a blood disorder in which there is anemia with larger-than-normal red blood cells (Macrocytic anemia).

Anemia is a condition in which the body does not have enough healthy red blood cells.

Red blood cells provide oxygen to body tissues. Megaloblastic anemia is mainly caused by a deficiency of folic acid or vitamin B12 which are required for DNA synthesis.

1- Alcohol abuse.
2- Certain inherited disorders.
3- Drugs that affect DNA, such as chemotherapy drugs.
4- Leukemia.
5- Myelodysplastic syndrome.
6- Myelofibrosis. Vitamin B12 deficiency anemia is a low red blood cell count due to a lack of vitamin B12. Leenah Al-Oufi
Roba Al-Hadlaq
Naelah Al-Ghamdi
Amal Al-Senan
Kholod Bin Taleb Pernicious anemia Pernicious anemia is a decrease in red blood cells that occurs when your intestines cannot properly absorb vitamin B12. Other causes: Definition: Causes: Vegetarian diet.
Chronic alcoholism.
Crohn's disease, celiac disease, infection with the fish tapeworm, or other problems that make it difficult for your body to digest foods.
Pernicious anemia.
Surgeries that remove certain parts of your stomach or small intestine, such as some weight-loss surgeries.
Taking antacids and other heartburn medicines for a long period of time. Definition: Causes: Atrophic gastritis.
An autoimmune condition in which the body's immune system attacks intrinsic factor protein or the cells that make it.
Very rarely, passed down through families (congenital pernicious anemia).
Associated with other diseases e.g: Addison's disease, Type 1 diabetes, Graves disease...etc. Folate-deficiency anemia is a decrease in red blood cells (anemia) due to a lack of folate. Folate is a type of B vitamin. It is also called folic acid. Definition: Causes: Too little folic acid in your diet.
Hemolytic anemia.
Long-term alcoholism.
Use of certain medications (such as methotrexate, pyrimethamine and barbiturates).
Poor diet.
Pregnancy. Folate Deficiency 1- Clinical picture General signs & symptoms of anemia.
Red beefy tongue in pernicious anemia.
Neurological manifestations:
- Peripheral neuritis & dementia
( B12 deficiency). Oval macrocyte (MCV=100-150 fl or greater), MCH with normal MCHC.

Hyper segmented neutrophils (more than 6 lobes).

Pancytopenia especially when the anemia is severe.


Basophilic stippling & Howell-Jolly bodies.

Nucleated RBCs (if hematocrit < 20%).

Broken erythrocytes & spherocytosis.

Ineffective erythropoiesis. 3- Bone marrow 4- Blood chemistry Elevated LDH (90%).
Serum B12 or folate low.
Serum iron elevated (N & ferritin may be high).
Schilling test (radiometric test of B12 absorbtion).
IF antibodies (Type 1 & 2 are highly specific for pernicious anemia - Rarely used).
Methylmalonic acid (MMA) & homocysteine. 2- Peripheral blood Erythroid & granulocytic hyperplasia (reversed from myeloid to erythroid) due to proliferation of erythroid precursors.

Increased mitotic activity.

RBCs are large, nucleated with finely dispersed chromatin & the cytoplasm is fully hemoglobinized.

Giant band cells & metamyelocytes.

Hyper segmented granulocytes.

Large megakaryocytes. 5- Imaging studies Abdominal X-ray films, upper & lower gastrointestinal tract (GIT).

CT scans may be useful for detecting & evaluating blind loop syndromes. *Serum folate is the earliest indicator of folate deficiency. B12 & folate levels Used to differentiate between single and combined defects. Supervised by: Dr. Lobna
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