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megaloblastic Anemia



Definition - Causes, incidence, and risk factors - Symptoms - Signs and tests - Treatment  - Expectations (prognosis) - Calling your health care provider    . 


Hypersegmented PMN (Close-up)


This image shows a large PMN with multiple discretely-identifiable nuclear lobes, usually seen in megaloblastic anemias. Normal PMN's have less than or equal to 5 lobes.

Definition    

Megaloblastic anemia is a blood disorder characterized by anemia, with red blood cells that are larger than normal, usually resulting from a deficiency of folic acid 
or of vitamin B-12.

Causes, incidence, and risk factors    

Deficiencies of vitamin B-12 and folic acid are the most common causes of megaloblastic anemia. Other causes are leukemia, myelofibrosis, multiple myeloma, certain hereditary disorders, drugs that affect DNA synthesis such as chemotherapy agents (methotrexate), alcohol, and other causes. Risk factors relate to the causes. (See also pernicious anemia).

Symptoms 

  • Loss of appetite
  • Diarrhea
  • Tingling and numbness of hands and feet
  • Pale skin color
  • Tiredness
  • Headaches
  • Sore mouth and tongue
  • Change in skin color

Signs and tests   

Examination of neurological signs may show abnormal reflexes, decreased position sense, and decreased vibration sense if related to vitamin B-12 deficiency.
Tests include:
  • Complete blood count (shows anemia with large red blood cells)
  • Bone marrow examination
  • Serum B-12
  • Schilling test (may identify poor absorption as cause of vitamin B-12 deficiency)
  • Serum folate

Treatment    


The objective of treatment is to determine the cause of the anemia, and the treatment depends upon the cause. Anemias related to vitamin deficiencies are discussed separately.

Expectations (prognosis)    

The outcome is expected to be good with treatment.
Complications    
Complications vary with the underlying cause.


Calling your health care provider   

Call for an appointment with your health care provider if symptoms develop.

Prevention   

Adequate intake of vitamin B-12 and folic acid is helpful.




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