is a decrease in red blood cells (anemia)
caused by folate
deficiency.
Causes, incidence, and risk factors
Folate, also
called folic acid, is necessary for red blood cell formation and growth. Folate
can be obtained from green leafy vegetables and liver. Some medications, such
as Dilantin (phenytoin), interfere with the absorption of this vitamin. Because
folate is not stored in the body in large amounts, a continual dietary supply
of this vitamin is needed.
In
folate-deficiency anemia, the red cells are abnormally large and are called
megalocytes, or megaloblasts in the bone marrow. Subsequently, this anemia may
be referred to as megaloblastic anemia
Causes of this
anemia are poor dietary intake of folic acid (as in chronic alcoholism), malabsorption
diseases such as celiac
disease (sprue), and certain medications. A relative deficiency due to
increased need for folic acid may occur in the third trimester of pregnancy.
Risk factors
include poor diet (seen frequently in the poor, the elderly, and in people who
do not eat fresh fruits or vegetables), eating overcooked food, alcoholism,
history of malabsorption diseases, and pregnancy. The disease occurs in about 4
out of 100,000 people.
The goal is to
treat the underlying cause of the anemia, which may be due to diet or a
malabsorption disease.
Oral or
intravenous folic acid supplements may be taken on a short-term basis until the
anemia has been corrected, or -- in the case of poor absorption by the
intestine -- replacement therapy may be lifelong.
Dietary
treatment consists of increasing the intake of green, leafy vegetables and
citrus fruits.
Expectations (prognosis)
Anemia usually
responds well to treatment within 2 months.
Complications
Symptoms of
anemia can cause discomfort. In a pregnant woman, folate
deficiency has been associated with neural tube or spinal defects (such as spina bifida)
in the infant.
