Rapid Facts About Macrocytic Anemia
●Only vitamin B12 and folate deficiency has macroovalocytes + hypersegmented
●Don’t forget that megaloblastic anemia has pancytopenia.
●in case of macrocytic anemia and pancytopenia don’t forget to think about
myelodysplastic syndrome and paroxysmal nocturnal hemoglobinuria.
●both alcohol and B12 deficiency causes neurological manifestations but alcohol
has NO hypersegmented neutrophils.
● B12 and folate deficiency causes increase in bilirubin and LDH. Distinguish it
from hemolysis by decreased reticulocyte.
● B12 levels can benormal in 30%,of patients with B12 deficiency because
transcobalamin is an acute phase reactant.
● Metformin can cause B12 deficiency byinterfering with absorption.
● Goat’s milk is poor in folate vitamin B12 and iron.
● Pernicious anemiais the most common causeof vitamin B12 deficiency.
●When treating vitamin B12 deficiency firststart with IM then oral.
●After correcting the B12 and folate deficiencies don’t forget to monitor potassium level because it will go down (Cellular regeneration).