Definition, etiology, pathophysiology, clinical manifestations, pharmacological and non pharmacological treatments.
Useful for D.pharm, b.pharm, pharm D and medical students
2. DEFINITION
Megaloblastic anaemia is also known as
• Folate deficiency anemia.
• Folic acid (Vitamin B9) deficiency anemia.
• Vit B12 (Cobalamin) deficiency anemia.
"Megaloblastic anemia is a type of anemia characterized by the formation of
unusually abnormal and immature red blood cells called as megaloblasts
by the bone marrow, which are released into the blood."
OR
Megaloblastic anemia is a red blood cell disorder due to the inhibition of
DNA synthesis during erythropoiesis (red blood cell production).
• A red blood cell disorder.
• Immature RBCs (megaloblast) are formed and released in the blood.
3.
4. ETIOLOGY
Deficiency of Cobalamine or Vitamin B12:Vitamin B12 is
an essential requirement for the formation of red blood
cells. It is absorbed from the diet by the digestive tract. It
may become deficient in the body due to following
reasons:
• Inadequate dietary intake.
• Failure of the body to absorb the vitamin B12.
• Drug Inhibition: Metformin, Proton pump inhibitors.
Deficiency of Folate: Folate may be deficient due to
following reasons:
• Inadequate dietary intake or malabsorption.
• Over cooked food especially vegetables.
• Increased requirements of body.
• Pregnancy and lactating mothers need more folic acid.
5. Role of Folic acid & Vitamin B12 in
RBCs production
Folic acid
Vitamin B9
Folate synthesis
Thyimidylate Synthetase
RBCs DNA Synthesis
6. PATHOPHYSIOLOGY
Deficiency of Vitamin B12 and folic acid.
Thymidylate synthetase٭function impaired.
DNA synthesis interrupted.
Failure of nuclear maturation.
Erythrocytes (RBCs) fails to proliferate.
Immature RBCs (megaloblasts) formed and released in the blood.
Megaloblastic Anemia.
7. CLINICAL MANIFESTATIONS
• Shortness of breath.
• Muscle weakness.
• Abnormal paleness of the skin.
• Loss of appetite.
• Nausea.
• Diarrhoea.
• Tingling in hands & feet.
8. TREATMENT
The first line of treatment is correcting nutritional deficiencies.
Pharmacological treatment includes Vitamin B12 and B9 Injections.
Food high in Vitamin B12:
Chicken.
Fortified grains.
Eggs.
Red meat.
Fish
Food high in folic acid:
Dark leafy green vegetables.
Beans, peanuts, soybean, barley and sprouts.
Lentils (pulses).
Oranges.
