Megaloblastic anemia

6/8/2020
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Developed by-Dr.Abdulrazzaq Othman Alagbare
M.D M.S.c C.P - Lecturer of Hematology and Immunohematology
What is a Megaloblastic Anemia? Anemias in which the RBCs are oval
macrocytes, with an MCV larger than normal (>115-150 fL).
Types of megaloblastic anemia Causes

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Megaloblastic Pernicious Non
anemia anemia Megaloblastic
anemia

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Causes of B12 and folic acid deficiency

Insufficient intake  Lack intake foods rich with vitamin B12 or folic acid

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 Increase of demands (Growth. Pregnancy.

Chemotherapy etc)

Absorption defect Post infectious diseases or parasitic infection.

Intrinsic factor Atrophic gastritis (elderly) no production, or • Post

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defect gastrectomy • autoimmune
Symptoms of Megaloblastic Anemia

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1. Symptoms of anemia

2. Neurological symptoms

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CBC result in megaloblastic anemia
Pancytopenia  in sever cases Low of all types of cells in the peripheral blood
RBC: WBC: Platelets
1-Hb; low Count : Low count low count
2-MCV over 94 up to 120 Blood smear: - Giant PLT

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fl Presence of polysegmented
3-MCH  low neutrophils with over 5 lobes
4-Retic-Count Low
Blood smear:
oval macrocytic RBC

Reticulocyte count: inadequate for the degree of anemia

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Pernicious anemia (PA)
 is a type of megaloblastic
anemia age of patient often >

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60 years old
 Same symptoms and Lab.
Finding with Megaloblastic
anemia

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 Pernicious anemia (PA) … Caused by…

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30% caused by gastritis or 70 % it is an autoimmune disease
gastroectomy etc.

auto-antibodies produced against

gastric parietal cells or against the IF
protein , leading to No intrinsic factor
secretion 7
 Case
Megaloblastic anemia B12-
Deficiency
Megaloblastic anemia –Folic
acid Deficiency
Pernicious anemia
The main diagnostic test
Decrease Serum level of B12
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Decrease Serum and red cell folate
level
Decrease Serum level of B12 and
Folic acid
70%  antibodies in there serum
for…
o Detecting anti partial antibodies
o Detecting anti IF antibodies 8
 NON MEGALOBLASTIC MACROCYTIC ANEMIA (Macrocytosis)

1-form of macrocytic anemia Causes of :

2-its has no the typical laboratory finding 1-Liver diseases

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of megaloblastic anemia 2-Alcholism
3-No related to folic acid deficiency Normally physiologic macrocytosis in
(especially alcoholism) 1. Pregnancy
5-The MCV is between 108-110 fl 2. New born

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Non Megaloblastic anemia – Liver Diseases

The PBS show

 Round macrocytes RBC

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that are usually seen in
alcoholism and obstructive liver
disease.

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 Macrocytes in true megaloblastic

conditions are oval

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macrocytes

 as opposed to the round macrocytes that

are usually seen in alcoholism and

obstructive liver disease. 11

Anemia of Chronic Liver Disease
The patient has sever liver disease
Risk factors
1- alcoholism

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2- folate deficiency
All that develop anemia characterized as
 Short RBC lived
 Low EPO production
PBS
• Normochromic normocytic ia anem
• Some cases are
macrocytic(MCV>100).
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• Mostly rounded Target cells
 ‫الحمد هلل رب‬
‫العالمين‬

‫‪6/8/2020‬‬
‫هذا ابتغاء مرضات‬
‫هللا‬

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