Jashore University of Science and Technology

Course Title: Advanced Nutrition 2

Course No: NFT-5201

Presented by Presented to
Md. Riazuddin Dr. Md. Shimul Islam
Roll: MS-210931 Associate professor
Dept. of Nutrition and Food Dept. of Nutrition and Food
Technology Technology
Jashore university of science Jashore university of science
and Technology. and Technology.
Greetings to all.
Welcome to my presentation.
My presentation topic is...

Megaloblastic macrocytic anemia

 Megaloblastic anemia

 What is megaloblastic anemia?

Megaloblastic anemia is characterised by the formation
of unusually large, abnormal and immature red blood
cells called megaloblasts by the bone marrow, which are
released into the blood.
 Etiological factor of megaloblastic anemia
 Vitamin B12 deficiency
 Folate deficiency
 Drugs
 Myelodysplastic syndrome
 Acute leukaemia
 Gastric surgery
 Family history
 Chronic gastritis.
 Folate and vitamin B12 metabolism
Nucleic acid synthesis
Methionine Homocysteine

Dihydrofolate
reductase
vitamin B12
Folate Dihydrofolate Tetrahydrofolat 5-methylene
e tetrahydrofolate

dUMP

Thymidylate
synthase 5,10-methylene
tetrahydrofolate

dTMP

dTTP

DNA synthesis
 Pathogenesis of megaloblastic anemia

Vitamin B12 and Hemoglobin

folate deficiency synthesis is normal

Normoblast with a Megaloblast with immature,

Impaired DNA
mature ink-blot large nucleus with sieve-like
synthesis
like small nucleus chromatin
Cytoplasm mature
(turns pink from blue
Delayed nuclear to hemoglobinization
maturation as it matures)

Cytoplasm matures (as

Nuclear: cytoplasmic amphophilic or pink), Intramedullary apoptosis
dyssynchrony nucleus is seen of precursors (ineffective
immature as sieve-like erythropoiesis)
with fine chromatin
 Summary mechanism of megaloblastic anemia

Megaloblastic anemia Macrocytic anemia

Large Giant
RBC metamyelocytes

Defective nuclear mechanism

1. Impaired DNA synthesis 1. Homocysteine Methionine

2. Delayed cell division 2. Synthesis of thymidine triphosphate
3. HB synthesis is normal
Need for

Needed for DNA

Deficiency synthesis
1.Vitamin B12
leads to
2. Folic acid
Have you any questions?