Megaloblastic Anemia

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Anemia is a blood disorder that results in the loss of red blood cells. Red blood cells transport oxygen through the body; without adequate amounts, tissues and organs suffer a lack of oxygen. Megaloblastic anemia is a blood disorder marked by the appearance of very large red blood cells.

In the case of megaloblastic anemia, this disorder is caused by incomplete formation of the red blood cell resulting in large numbers of immature and incompletely developed cells. These red blood cells do not function like healthy red blood cells and crowd out the healthy cells, causing anemia. Since these cells are underdeveloped, and they also have a short life expectancy.

Causes of Megaloblastic Anemia

The two most common causes of megaloblastic anemia are deficiencies of either folic acid, or of vitamin B12. When the cause is a lack of vitamin B12 due to malabsorption in the intestines, it is called pernicious anemia. Other causes can include alcohol abuse, chemotherapy, leukemia, certain medications, and some genetic conditions. Although this anemia can be diagnosed in anyone, it is most often diagnosed in those of Northern European ancestry.

What Are the Symptoms of Megaloblastic Anemia?

Symptoms can vary among individuals with the condition, but common symptoms include:

• fatigue
• muscle weakness
• loss of appetite/weight loss
• diarrhea
• nausea
• fast heartbeat
• smooth or tender tongue
• tingling in hands and feet
• numbness in extremities


Diagnosing Megaloblastic Anemia

This kind of anemia is usually found during routine blood tests. These can include a complete blood count (CBC) and a red blood cell folate level check. Your doctor will also gather your medical history and perform a physical exam. This is to rule out other causes of your symptoms. One test that can aid with diagnosis is the Schilling test.
Blood Picture of Megaloblastic Anemia. The cells marked by arrows include abnormally large RBCs and multinucleated  (>2 to 4 nucleus) neutrophils.

The Schilling test is a blood test that evaluates vitamin B12 absorption. After you consume radioactive B12, a urine sample is then evaluated. If there is minimal or no B12 in your urine, you may not be absorbing the vitamin. In healthy individuals, the intestine takes up excess B12 and gets rid of the excess through urine.

How Is Megaloblastic Anemia Treated?

Treatment for megaloblastic anemia depends on the underlying reason for the anemia. It will also take into consideration your age, overall health, your tolerance and response to treatments, and the severity of the disease. Treatment is ongoing. This is to ensure your anemia does not return.

For a general lack of vitamin B12 or pernicious anemia, you may need monthly injections of the vitamin. Oral supplements may also be given. Adding more foods with vitamin B12 to your diet can help. Such foods include eggs, chicken, fortified cereals, milk, and shellfish.

Megaloblastic anemia caused by a lack of folic acid may be treated with oral or intravenous folic acid supplementation. Dietary changes also help boost folic acid levels. Foods to include in your diet are oranges, leafy vegetables, peanuts, lentils, and asparagus.

Catching megaloblastic anemia early is important. If the body sustains a lack of vitamin B12 for a long period of time, permanent nerve damage can occur.

Considerations of Megaloblastic Anemia

Vitamin B12 is typically found in animal products. If you have a lack of vitamin B12 due to dietary restrictions, talk with your doctor about alternative ways to reduce your risk of the anemia recurring. You might need additional supplementation.

For a case study regarding Megaloblastic Anemia, click here. It will provide information on all aspects of disease.

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