Tags

Type your tag names separated by a space and hit enter

Megaloblastic anemia in patients receiving total parenteral nutrition without folic acid or vitamin B12 supplementation.
Can Med Assoc J. 1977 Jul 23; 117(2):144-6.CM

Abstract

Pancytopenia developed in four patients receiving postoperatively total parenteral nutrition (TPN). Symptoms and signs were related mainly to underlying bowel disease. Hematologic abnormalities, first noted from 4 to 7 weeks following institution of TPN, consisted of normocytic anemia (mean decrease in hemoglobin value, 2.2 g/dL), occasional macrocytes being noted, leukopenia (range of leukocyte counts, 1.2 to 3.6 X 10(9) L), some hypersegmented neutrophils being detected, and clinically significant thrombocytopenia (range of platelet counts, 25 to 52 X 10(9)/L). In all patients the bone marrow showed megaloblastic changes, with ring sideroblasts, although pyridoxine was included in the TPN regimens. Serum vitamin B12 values were normal in one patient and at the lower limit of normal in the other two patients in whom it was measured, while serum or erythrocyte folate values, or both, were reduced in three patients. Full hematologic response was observed in the four patients after folic acid replacement therapy; leukocytosis and thrombocytosis were noted in three. Thus, folic acid and possibly vitamin B12 should be added routinely to TPN regimens to prevent deficiency of either substance.

Authors

No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

406033

Citation

Denburg, J, et al. "Megaloblastic Anemia in Patients Receiving Total Parenteral Nutrition Without Folic Acid or Vitamin B12 Supplementation." Canadian Medical Association Journal, vol. 117, no. 2, 1977, pp. 144-6.
Denburg J, Bensen W, Ali MA, et al. Megaloblastic anemia in patients receiving total parenteral nutrition without folic acid or vitamin B12 supplementation. Can Med Assoc J. 1977;117(2):144-6.
Denburg, J., Bensen, W., Ali, M. A., McBride, J., & Ciok, J. (1977). Megaloblastic anemia in patients receiving total parenteral nutrition without folic acid or vitamin B12 supplementation. Canadian Medical Association Journal, 117(2), 144-6.
Denburg J, et al. Megaloblastic Anemia in Patients Receiving Total Parenteral Nutrition Without Folic Acid or Vitamin B12 Supplementation. Can Med Assoc J. 1977 Jul 23;117(2):144-6. PubMed PMID: 406033.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Megaloblastic anemia in patients receiving total parenteral nutrition without folic acid or vitamin B12 supplementation. AU - Denburg,J, AU - Bensen,W, AU - Ali,M A, AU - McBride,J, AU - Ciok,J, PY - 1977/7/23/pubmed PY - 1977/7/23/medline PY - 1977/7/23/entrez SP - 144 EP - 6 JF - Canadian Medical Association journal JO - Can Med Assoc J VL - 117 IS - 2 N2 - Pancytopenia developed in four patients receiving postoperatively total parenteral nutrition (TPN). Symptoms and signs were related mainly to underlying bowel disease. Hematologic abnormalities, first noted from 4 to 7 weeks following institution of TPN, consisted of normocytic anemia (mean decrease in hemoglobin value, 2.2 g/dL), occasional macrocytes being noted, leukopenia (range of leukocyte counts, 1.2 to 3.6 X 10(9) L), some hypersegmented neutrophils being detected, and clinically significant thrombocytopenia (range of platelet counts, 25 to 52 X 10(9)/L). In all patients the bone marrow showed megaloblastic changes, with ring sideroblasts, although pyridoxine was included in the TPN regimens. Serum vitamin B12 values were normal in one patient and at the lower limit of normal in the other two patients in whom it was measured, while serum or erythrocyte folate values, or both, were reduced in three patients. Full hematologic response was observed in the four patients after folic acid replacement therapy; leukocytosis and thrombocytosis were noted in three. Thus, folic acid and possibly vitamin B12 should be added routinely to TPN regimens to prevent deficiency of either substance. SN - 0008-4409 UR - https://www.unboundmedicine.com/medline/citation/406033/Megaloblastic_anemia_in_patients_receiving_total_parenteral_nutrition_without_folic_acid_or_vitamin_B12_supplementation_ L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/406033/ DB - PRIME DP - Unbound Medicine ER -