Megaloblastic Anemia

By:
Narvacan, Eunice M.
DDM-1
What is Megaloblastic Anemia?

• a blood disorder in which there is

anemia with larger-than-normal red
blood cells
 Causes, Incidence, Factors of
Megaloblastic Anemia
• Megaloblastic anemia is usually
caused by a deficiency of folic
acid or vitamin B12
• Other causes are:
– Alcohol abuse
– Certain inherited disorders
– Drugs that affect DNA, such
as chemotherapy drugs
 Symptoms
 Change in skin color
 Diarrhea
 Headaches
 Loss of appetite
 Pale skin color
 Sore mouth and tongue
 Tingling and numbness of hands and
feet
 Tiredness
 Pathophysiology
• Megaloblastic anemia
– caused by various DNA synthesis defects
• In folate deficiency
– purine biosynthesis is affected because
folic acid is essential in this process.
• Folic acid absorbed from the diet must be
activated to produce active tetrahydrofolic
acid (THF)
• THF is necessary for single carbon transfers
in the synthesis of pyrimidine nucleotides.
• Without adequate levels of biologically
active THF
– the ability to repair and replicate DNA is
decreased
• Vitamin B-12
– A cofactor for the activation of folic acid in a step
that also converts homocysteine to methionine.
• Inadequate folic acid intake
– THF production is depleted, and DNA synthesis is
slowed
• Effect on hematopoiesis is to reduce the
rate of cell production
• Cells that are produced have immature
nuclei compared to the degree of
maturation of the cytoplasm
 Treatment
• Medical Care
– Most patients with megaloblastosis are
treated with cobalamin and folate
therapy to treat deficiencies in these
substances
– Transfusion therapy should be restricted
to patients with severe, uncompensated,
and life-threatening anemia. Because
megaloblastic anemias usually develop
gradually, most patients have adjusted to
low Hgb levels and do not require
transfusions.
 Treatment: Diet
• Patients should include rich sources of
folate in their diets
– asparagus, broccoli, spinach, lettuce, lemons,
bananas, melons, liver, and mushrooms
• To prevent loss of folate, foods should not
be cooked excessively, especially in large
amounts of water.
• To prevent cyanocobalamin deficiency,
patients who prefer vegetarian diets
should include fish meat, dairy products
and eggs in their meals