Thalassemic syndromes Heterozygous beta thalassemia Other hemoglobinopathies Artifact in the presence of Hb S Some Hb variants with thalassemic phenotype Acquired conditions Megaloblastic anemia
Hyperthyroidism Pseudoxanthoma elasticum Hypertrophic osteoarthropathy Treatment-related conditions Antiretroviral therapy in patients with HIV
The peripheral smear findings such as macrocytes, macroovalocytes, cabot's ring, basophilic stippling, and hypersegmented neutrophils can help to get differential diagnosis of anemia due to deficiency of vitamin B12; that is megaloblastic anemia
Key Words: Leukemia, Megaloblastic Anemia
, Aplastic Anemia
Hungry bone syndrome is a severe complication of neglected primary hyperparathyroidism, which associated with iron-deficiency, megaloblastic anemia
and bone fibrosis, besides the renal failure, suggests that the severity was determined by the term of hyperparathyroidism and the increased number of complications.
and vitamin B12 deficit were reported in 1 and 5 patients, respectively (36-38).
Such diverse pathologic causes can be present in different diseases such as aplastic anemia (AA), megaloblastic anemia
(MA), myelodysplastic syndromes (MDS), acute leukemia, hairy cell leukemia, myelofibrosis with myeloid metaplasia (MMM), lymphomatous or metastatic involvement of bone marrow, leishmaniasis, hemolytic diseases such as systemic lupus erythematous (SLE), hypersplenism and many other diseases.
Different types of anemia, including iron deficiency anemia (IDA), anemia of chronic disease (ACD), the combination of IDA and ACD (COMBI) anemia, megaloblastic anemia
, and hemolytic anemia, have been seen in patients with RA.
In fact, vitamin B12 deficiency is serious business, which can result in megaloblastic anemia
(a blood disorder with larger than normal red blood cells) and symptoms that may include numbness and tingling in the arms, difficulty walking, memory loss, and disorientation.
4 Table 2 Relationship between clinical manifestation of B12 deficit and geriatric syndromes Clinical manifestation of B12 deficit Geriatric syndrome Hematological: Megaloblastic anemia
Anergy Pancytopenia Neurological: Sub-acute combined Dizziness, syncope degeneration of spine Polyneuropathies Falls Cerebral syndromes Frailty Optic neuropathy Functional decline Cerebrovascular disease Failure to thrive Gastrointestinal: Diarrhea Anorexia of aging Weight loss Cachexy Protein-energy malnutrition Skin and mucosa: Hunter's glossitis Mucocutaneous ulcers Angular cheilitis Cardiovascular: Atherosclerosis Dizziness Coronary disease Syncope (hyperhomocysteinemia) Venous thromboembolism Falls Psychiatric: Dementia Cognitive decline Falls Frailty
4% are suffering from pernicious anemia, a variant of megaloblastic anemia
which , is caused by deficiency or defective absorption of vitamin B12 in adults and folate deficiency in children resulting into oral ulceration, mucosal bleeding and glossitis12,13.
High-dose oral B12 ([greater than or equal to] 1000 mcg/d) can cure cobalamin deficiency, and may also induce and maintain remission in patients with megaloblastic anemia
Objective: The study was carried out to find the cause of megaloblastic anemia