Diagnosis of Megaloblastic Anaemia and Treatment —

megaloblastic anemia -sickle cell anemia

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 erythropoiesis.
  • 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. Hemodialysis
  • 13. Dihydrofolate reductase deficiency.

Clinical features symptoms of megaloblastic anaemia —

  • Weakness, giddiness, vertigo, palpitations, angina, anorexia, weight loss, diarrhoea, peripheral nerve disease, 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.


One of the 1st in India.High Quality Generic Medicine Portal Android Application for Online Oreder & Information.

For More Join Our Membership and Get Additional 25% off on Meds, also get MLM Benefits to get a permanent earning source.

Join Membership How to Search Medicine
Android App

We would like to keep you updated with special notifications.