Megaloblastic anemia is a type of anemia characterized by the presence of abnormally large red blood cells (megaloblast) in the bone marrow and peripheral blood. It is primarily caused by a deficiency of vitamin B12 or folate, both essential for DNA synthesis and red blood cell production.
Large immature red blood cells (megaloblasts) in the bone marrow because the RBCs are too big. Some may be unable to exit the bone marrow to enter the bloodstream and deliver oxygen. They also die earlier than normal RBCs. The number of RBCs is also reduced without an adequate B12 or folate, RBCs do not divide properly leading to larger than normal cells.
Known As: Macrocytic Anemia
Sources of Vitamin B12 and Folate:
Vitamin B12 Folate
Animal-based sources like Plant-based sources like
Meat Brussel sprouts
Egg Avocado’s, Orange
Seafood Leafy green vegetables and peanuts
Causes of Megaloblastic Anemia:
- Decrease intake of Vitamin B12 or folate poor absorption- Celiac disease deficiency of intrinsic factor (pernicious) gastrectomy, alcohol
- Increase the need for pregnancy, lactation, and young children.
Signs and Symptoms of Megaloblastic Anemia:
- Fatigue
- Shortness of breath
- Paler skin
- Fast heartbeat
- Fainting and weak
- Vitamin B12 deficiency, neuropathy (tingling, numberless in hands and feet)
- Glossitis
- Loss of appetite
Diagnostic Tests of Megaloblastic Anemia:
- CBC and HB count, MCV, PCV, hyper-segmented neutrophil
- Peripheral smear
- Serum B12 levels, and folate levels
- Intrinsic factor antibody test
- Reticulocyte count
- Homocysteine and methylmalonic acid levels
- Schilling test- test to access Vitamin B12 absorption in the body
Treatment of Megaloblastic Anemia:
- Vitamin B12 and folic acid-rich diet
- Vitamin B12 folic acid supplements
- Identify and treat the cause – pernicious anemia destruction of intrinsic factor IM vitamin B12 is given lifelong.
- Regular monitoring
- Management of symptoms