Megablasic anaemia
Deficiency of Vitamin B12 and folic acid results imapir maturation of red blood cells leading to formation of abnormally large erythrocytes called Megaloblasts.
When deficiency of vitamin B12 or folic acid occur, the rate of DNA and RNA synthesis is reduced, delaying cell division. Thus cell get extra time between division, so grow larger than normal, formation of megaloblasts called Megaloblastic anaemia.
Etiology
Megaloblastic anemia results from deficiency of vitamin B12 or folic acid.
1. Inadequate dietary intake of vitamin B12 or folic acid is seen in exclusively breast fed infants.
2. Malabsorption of iron due to chronic diarrhea, celiac disease, crohn's disease.
3. Treatment with anticonvulsants drug such as phenytoin
4. Intrinsic defect of folic acid absorption
5. Increased demand of Vitamin B12 or folic acid.
6. Excess urinary folate loss for example; liver disease, kidney disease
7. Chemotherapy drug
Clinical features
1. Pallor
2. Irritability
3. Sick look
4. Failure to thrive
5. Anorexia
6. Increase pigmentation of back of hand, fingers and nose.
7. Tremors
8. Neurological manifestations such as; numbness, paraesthesia, weakness, ataxia, diminished reflexes.
Diagnostic Evaluation
1. History of children
2. Peripheral blood film
3. Serum vitamin B12 and folic acid assay
Management
Administration of folic acid dose 2-5mg/day and Vitamin B12 1μg/day.
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