Megaloblastic Anemia (Pernicious Anemia)

What is megaloblastic (pernicious) anemia?
Megaloblastic anemia, also called pernicious anemia, is a blood disorder in which there is anemia with red blood cells that are larger than normal. In addition to the cells being large, the inner contents of each cell are not completely developed. This malformation causes the bone marrow to produce fewer cells that die earlier than the 120-day life expectancy. Instead of being round or disc-shaped, the red blood cells can be oval. Megaloblastic anemia usually results from a deficiency of folic acid or of vitamin B-12.

What’re causes of megaloblastic (pernicious) anemia?
Deficiencies of vitamin B12 and folic acid are the most common causes of megaloblastic anemia. Other causes include:

Digestive diseases. Megaloblastic anemia is caused by certain diseases of the lower digestive tract ( include celiac disease, chronic infectious enteritis, and enteroenteric fistulas). Pernicious anemia is a type of megaloblastic anemia caused by an inability to absorb Vitamin B-12 due to a lack of intrinsic factor in gastric secretions.
Malabsorption. Inherited congenital folate malabsorption, a genetic problem in which infants cannot absorb folic acid in their intestines, can lead to megaloblastic anemia.
Drugs that affect DNA synthesis such as chemotherapy drugs, include phenytoin, primidone, and phenobarbital, can impair the absorption of folic acid.
Other causes are leukemia, myelodysplastic syndrome, myelofibrosis, alcohol abuse.
What’re symptoms of megaloblastic (pernicious) anemia?

The following are the most common symptoms of megaloblastic anemia:
Change in skin color
Diarrhea
Headaches
Loss of appetite
Pale skin color
Sore mouth and tongue
Tingling and numbness of hands and feet
Tiredness
How is diagnosis of megaloblastic (pernicious) anemia?
Megaloblastic (pernicious) anemia is usually discovered during a medical examination through a routine blood test. Diagnostic procedures for megaloblastic (pernicious) anemia may include:
Complete blood count (shows anemia with large red blood cells)
Bone marrow examination (can help show whether your bone marrow is healthy and making enough red blood cells)
Serum B12 (can help show vitamin B12 blood level)
Schilling test (detect vitamin B12 absorption)
Serum folate (can help show whether you have pernicious anemia or another type of anemia)

How is treatment of megaloblastic (pernicious) anemia?
The goal of treatment for megaloblastic (pernicious) anemia include preventing or treating the anemia and its signs and symptoms ; controlling complications, such as heart and nerve damage. The treatment depends on the cause. If the disorder is caused by an absorption problem in the digestive tract, this may need to be treated first. Usually treatment may include vitamin B12 injections and folic acid supplement.

Monthly vitamin B12 injections are prescribed to correct the vitamin B12 deficiency. This therapy corrects the anemia and may correct the neurological complications if taken soon enough. For less severe megaloblastic (pernicious) anemia, you should take large doses of vitamin B12 pills. A vitamin B12 nose gel and spray also are available. A well-balanced diet is essential to provide other elements for healthy blood cell development, such as folic acid, iron, and vitamin b12.

Which foods are contain rich folic acid and vitamin B12:
eggs
meat
poultry
milk
shellfish
fortified cereals

How is prevention of megaloblastic (pernicious) anemia?
If pernicious anemia is caused by a lack of intrinsic factor, you can’t prevent. If megaloblastic (pernicious) anemia is caused by not get enough vitamin B12 and folic acid in their diets, adequate intake of vitamin B-12 and folic acid is helpful.

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