Diagnosis of Megaloblastic Anaemia and Treatment —

Megaloblastic Anaemia

• The megaloblastic anaemias are disorders caused by impaired synthesis of DNA.
• Due to slow cell division, the cells are large, called megaloblastic cells, with more RNA than DNA.
• There may also be ineffective erythropoiesisHyperbilirubinemia Classification Types Symptoms Examination. Read more ... ».
• Most megaloblastic anaemias are due to deficiency of cobalamin j vitamin B₁₂ and deficiency of folic acid.
• Normal range of cobalamin in blood is 300 – 900 pgj ml. Less than 200 pgjml gives rise to significant defi­ciency features.
• Normal serum concentration of folic acid ranges from 6 – 20 ngjml. Less than 4 ngjml is significant folate deficiency.

Types of megaloblastic anaemia’s –

• 1. Gastric achlorhydria
• 2. Inadequate intake especially in pure vegetarians
• 3. Pernicious anaemia
• 4. ‘Congenital absence of intrinsic factor
• 5. Tropical sprue
• 6. Regional enteritis
• 7. Non-tropical sprue
• 8. Drugs like colchicine, neomycin, methotrexate, azathioprine, pyrimethamine, triamterene di­uretic.
• 9. Alcoholics
• 10. Pregnancy
• 11. Malignancy
• 12. HemodialysisDialysis Indications Complications and Dialysis for Renal Failure. Read more ... »
• 13. Dihydrofolate reductase deficiency.

Clinical features symptoms of megaloblastic anaemia –

• Weakness, giddinessDizziness cause diagnosis treatment. Read more ... », vertigo, palpitations, angina, anorexia, weight loss, diarrhoeaInfections CHOLERA Caused by Vibrio cholerae with diagnosis Treatment Signs and symptoms. Read more ... », peripheral nerve diseaseAortic Regurgitation Symptoms of Aortic Regurgitation Aortic Regurgitation TREATMENT. Read more ... », demyelination of posterior and lateral col­umns-numbness, paraesthesia, weakness, ataxias; sphincter disturbances, dementia, psychosis.
• Neurological disease may occur even with normal hematocrit and normal RBC indices.
• In pernicious anaemia, the above features are seen along with other diseases of similar immunologic ori­gin, like Grave’s disease, vitiligo, and hypothyroid­ism.
• Pernicious anaemia is more common in elderly and rare below 30 years.

Treatment of Magloblastic Anaemia –

• Intramuscular cyanocobalamin – 100 IJg j week for 8 wks followed by 1000 IJgm intramuscular every month.
• For practically whole life, 2 mg crystalline B₁₂ may be given orally daily.
• Reticulocytosis occurs 5 days after therapy and pa­tients improve within a week.
• For severe cases-blood transfusion, packed RBCs, exchange transfusions may be given.
• Folates and cobalamin both must be given because the neurologic manifestations may be aggravated by giving folate alone.
• Cobalamin and folate deficiency may present without anaemia with neurologic manifestations only.
• Folic acid 1 – 5 mgjday orally is given.
• The patient must be advised to take balanced diet.

This is the short description of magloblastic anaemia.