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.

We would like to keep you updated with special notifications.