Alternate Names: Anemia - megaloblastic

Causes and Risks: Deficiencies of vitamin B-12 and folic acid are the most common causes of megaloblastic anemia. Other causes are leukemia, myelofibrosis, multiple myeloma, certain hereditary disorders, drugs that affect nucleic acid metabolism such as chemotherapy agents (methotrexate), and other causes. Risk factors relate to the causes. (See also pernicious anemia).

Prevention: Adequate intake of vitamin B-12 and folic acid is helpful.

Symptoms:

• loss of appetite
• diarrhea
• tingling and numbness of hands and feet
• pale skin color
• tiredness
• headaches
• sore mouth and tongue
• pale skin color or jaundice

Signs and Tests: Examination of neurological signs shows abnormal reflexes, decreased position sense, and decreased vibration sense.

Tests include:

• CBC results showing low hematocrit with elevated MCV
• bone marrow examination
• serum LDH
• below normal serum B12 level
• Schilling test
• serum folate level
• elevated ferritin

Treatment: The objective of treatment is to determine the cause of the anemia, and the treatment depends upon the cause. Anemias related to vitamin deficiencies are discussed separately.

Prognosis: The outcome is expected to be good with treatment.

Complications: Complications vary with the underlying cause

Call for an appointment with your health care provider if symptoms develop.