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Clinico-aetiologic profile of macrocytic anemias with special reference to megaloblastic anemia.

Abstract

PURPOSE OF STUDY

This study was conducted to study the clinical and laboratory parameters in patients with macrocytic anemia and to determine the etiology of macrocytic anemia with special reference to megaloblastic anemia.

MATERIALS AND METHODS

This study was a cross-sectional descriptive study carried over a period of 18 months on 60 adult patients (age ≥13 years) of macrocytic anemia. Macrocytic anemia was identified when peripheral blood examination showed anemia with a mean red blood corpuscular volume of >95 fl.

RESULT

The most common cause of macrocytic anemia was megaloblastic anemia (38.4%). The major causes of nonmegaloblastic macrocytic anemia were primary bone marrow disorders (35%), liver diseases (15%) and hemolytic anemia (8.3%). There was a significant male preponderance in the study (65%). The megaloblastic anemias observed were due to either vitamin B(12) deficiency (78.3%) or combined B(12) and folate deficiency (21.7%). A significant proportion of non-vegetarians (73.9%) had megaloblastic anemia. Patients with an MCV of >110fl were more likely to have megaloblastic anemia (p value 0.0007). Three patients (mean age 55 years) with a megaloblastic marrow did not respond to vitamin replacement and were found to have myelodysplastic syndrome.

CONCLUSION

Megaloblastic anemia due to Vitamin B(12) or folate deficiency remains the most important cause of macrocytic anemia. In settings with limited laboratory facilities, a therapeutic trial of vitamins B(12) or folic acid is useful in determining the specific vitamin deficiency.

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  • Authors+Show Affiliations

    ,

    Department of Medicine, Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Puducherry, 605 006 India.

    , , ,

    Source

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    23100955

    Citation

    Unnikrishnan, Vineetha, et al. "Clinico-aetiologic Profile of Macrocytic Anemias With Special Reference to Megaloblastic Anemia." Indian Journal of Hematology & Blood Transfusion : an Official Journal of Indian Society of Hematology and Blood Transfusion, vol. 24, no. 4, 2008, pp. 155-65.
    Unnikrishnan V, Dutta TK, Badhe BA, et al. Clinico-aetiologic profile of macrocytic anemias with special reference to megaloblastic anemia. Indian J Hematol Blood Transfus. 2008;24(4):155-65.
    Unnikrishnan, V., Dutta, T. K., Badhe, B. A., Bobby, Z., & Panigrahi, A. K. (2008). Clinico-aetiologic profile of macrocytic anemias with special reference to megaloblastic anemia. Indian Journal of Hematology & Blood Transfusion : an Official Journal of Indian Society of Hematology and Blood Transfusion, 24(4), pp. 155-65. doi:10.1007/s12288-008-0039-2.
    Unnikrishnan V, et al. Clinico-aetiologic Profile of Macrocytic Anemias With Special Reference to Megaloblastic Anemia. Indian J Hematol Blood Transfus. 2008;24(4):155-65. PubMed PMID: 23100955.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Clinico-aetiologic profile of macrocytic anemias with special reference to megaloblastic anemia. AU - Unnikrishnan,Vineetha, AU - Dutta,Tarun Kumar, AU - Badhe,Bhawana A, AU - Bobby,Zachariah, AU - Panigrahi,Ashish K, Y1 - 2009/01/11/ PY - 2008/06/03/received PY - 2008/09/18/accepted PY - 2012/10/27/entrez PY - 2008/12/1/pubmed PY - 2008/12/1/medline KW - Bone marrow disorders KW - Macrocytic anemia KW - Megaloblastic anemia KW - Myelodysplastic syndrome KW - Non-megaloblastic macrocytic anemia SP - 155 EP - 65 JF - Indian journal of hematology & blood transfusion : an official journal of Indian Society of Hematology and Blood Transfusion JO - Indian J Hematol Blood Transfus VL - 24 IS - 4 N2 - PURPOSE OF STUDY: This study was conducted to study the clinical and laboratory parameters in patients with macrocytic anemia and to determine the etiology of macrocytic anemia with special reference to megaloblastic anemia. MATERIALS AND METHODS: This study was a cross-sectional descriptive study carried over a period of 18 months on 60 adult patients (age ≥13 years) of macrocytic anemia. Macrocytic anemia was identified when peripheral blood examination showed anemia with a mean red blood corpuscular volume of >95 fl. RESULT: The most common cause of macrocytic anemia was megaloblastic anemia (38.4%). The major causes of nonmegaloblastic macrocytic anemia were primary bone marrow disorders (35%), liver diseases (15%) and hemolytic anemia (8.3%). There was a significant male preponderance in the study (65%). The megaloblastic anemias observed were due to either vitamin B(12) deficiency (78.3%) or combined B(12) and folate deficiency (21.7%). A significant proportion of non-vegetarians (73.9%) had megaloblastic anemia. Patients with an MCV of >110fl were more likely to have megaloblastic anemia (p value 0.0007). Three patients (mean age 55 years) with a megaloblastic marrow did not respond to vitamin replacement and were found to have myelodysplastic syndrome. CONCLUSION: Megaloblastic anemia due to Vitamin B(12) or folate deficiency remains the most important cause of macrocytic anemia. In settings with limited laboratory facilities, a therapeutic trial of vitamins B(12) or folic acid is useful in determining the specific vitamin deficiency. SN - 0971-4502 UR - https://www.unboundmedicine.com/medline/citation/23100955/Clinico_aetiologic_profile_of_macrocytic_anemias_with_special_reference_to_megaloblastic_anemia_ L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23100955/ DB - PRIME DP - Unbound Medicine ER -