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         Megaloblastic Anemia:     more detail
  1. Nutritional Anemias: Scurvy, Pernicious Anemia, Iron Deficiency Anemia, Folate Deficiency, Megaloblastic Anemia
  2. The Megaloblastic Anemias by L.J. Davis, Alexander Brown, 1953
  3. Megaloblastic Anemia
  4. The Megaloblastic Anemias. Modern Medical Monographs 18 by M D, Victor Herbert, 1959
  5. Anemia: An entry from Thomson Gale's <i>Gale Encyclopedia of Science, 3rd ed.</i> by Larry Blaser, 2004
  6. HealthScouter Anemia: Symptoms of Anemia and Signs of Anemia: Anemia Patient Advocate (HealthScouter Anemia)
  7. Nutritional megaloblastic anemias (Diagnostic criteria) by John J Will, 1966
  8. Idiopathic chronic megaloblastic anemia in children (Acta paediatrica. Supplementum) by Olga Imerslund, 1959
  9. Megaloblastic anaemia by V. I Mathan, 1967
  10. Gale Encyclopedia of Alternative Medicine: Vitamin B<SUB>12</SUB> by Judith Turner, 2001-01-01
  11. The Megaloblastic Anaemias by I. Chanarin, 1991-01-15
  12. Folates and Cobalamines by J. A. Zittoun, 1989-09

1. MEGALOBLASTIC ANEMIAS
An article by Thomas G. DeLoughery, Associate Professor of Medicine discussing all aspects of this disorder.Category Health Conditions and Diseases Anemia Megaloblastic...... The LDH level is often in the 1,000's in patients with megaloblastic anemia. THERAPY.Patients with severe megaloblastic anemia need immediate therapy.
http://www.ohsu.edu/som-hemonc/handouts/deloughery/megalobl.shtml
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fax Home Welcome News Adult Bone Marrow Transplantation ... PRINT VERSION Thomas G. DeLoughery
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MEGALOBLASTIC ANEMIAS MACROCYTOSIS An increased MCV can be due to a number of reasons but careful review of the patient's history and blood smear can narrow the diagnostic possibilities. The differential can be divided into two broad categories based on RBC morphology. Round macrocytosis-due to abnormal lipid composition of the erythrocyte membrane. Common etiologies include:
  • Alcoholism. Liver Disease. Renal Disease. Hypothyroidism ("myxedema of the red cell").
  • Oval macrocytosis (macroovalocytes) is a sign of problem with cell DNA replication. The developing red cell has difficulty in undergoing cell division but RNA continues to be translated and transcribed into protein leading to growth of the cytoplasm while the nucleus lags behind. Often one or more cell division are skipped leading to a larger than normal cell. Common causes are:
  • Drug effect including cytotoxic chemotherapy (AZT now most common etiology of increased MCV).
  • 2. MEDLINEplus Medical Encyclopedia: Megaloblastic Anemia
    megaloblastic anemia is a blood disorder characterized by anemia, with red blood cells that are larger than normal,
    http://www.nlm.nih.gov/medlineplus/ency/article/000567.htm
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    Megaloblastic anemia
    Contents of this page:
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    Megaloblastic anemia - view of red blood cells Hypersegmented PMN (Close-up) Blood cells Alternative names Return to top Anemia - megaloblastic Definition Return to top Megaloblastic anemia is a blood disorder characterized by anemia, with red blood cells that are larger than normal, usually resulting from a deficiency of folic acid or Vitamin B-12 Causes, incidence, and risk factors Return to top Deficiencies of Vitamin B-12 and folic acid are the most common causes of megaloblastic anemia. Other causes are leukemia myelofibrosis multiple myeloma , certain hereditary disorders, drugs that affect DNA synthesis such as chemotherapy agents (methotrexate), alcohol, and other causes. Risk factors relate to the causes. (See also pernicious anemia Symptoms Return to top Signs and tests Return to top Examination of neurological signs may show abnormal reflexes, decreased position sense, and decreased vibration sense if related to Vitamin B12 deficiency.

    3. Megaloblastic Anaemia
    Haematological profile, diagnosis and treatment of megaloblastic anemia. Vitamin B12 deficiency and frolic acid deficiency.
    http://www.uq.edu.au/vdu/HDUAnaemiaMegaloblastic.htm

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    Megaloblastic Anaemia Diagnosis
    • Many cases are seen that have a decreased serum B12 with a normal haematological profile and possibly normal clinical findings
    • Test for methylmalonic acid in the serum as an indicator of vitB12 deficiency
    • Test for homocysteine to check folate levels
    Haematological Profile
    • Hb/RCC/Hct - Dec (due to Dec. DNA production)
    • MCV/MCH - Inc. (As precursors are megaloblastic)
    • MCHC - Normal
    • RDW - Inc. (Anisocytosis due to microcytes, normocytes and oval macrocytes)
    • Plt./WCC - Dec
    • Pancytopaenia with a normochromic, macrocytic anaemia
    • Intramedullary haemolysis due to ineffective erythropoiesis (reason for hypercellular BM)
    • Poikilocytosis - ++ (tear drops and schistocytes)
    • Anisocytosis - +++ (oval macrocytes)
      • A "Shift-to-the-Left" indicates an Inc. in band form WBCs
    • Hypercellular bone marrow (M:E at 1:1 or reversed)
    • Erythron
      • Large cells with fine chromatin (Megaloblasts)
      • Nuclear(N)/Cytoplasmic(C) dissociation with N lagging C - normal cytoplasmic maturation
      • Multiple Howell-Jolly bodies (diagnostic if observed)
    • Leucon
      • Giant myelocytes and metamyelocytes
    • Thrombon
      • Often not obvious
    • The peripheral blood (PB) and bone marrow (BM) findings do not distinguish between a vitamin B12/cobalamin deficiency and a folic acid (folate) deficiency

    4. Anemia, Macrocytic
    CBC with megaloblastic anemia, diagram U. of Utah Webpath; Hypersegmented neutrophilwith megaloblastic anemia on smear, microscopic U. of Utah Webpath;
    http://www.ohsu.edu/cliniweb/C15/C15.378.71.252.html
    Anemia, Macrocytic
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    5. Genetic Mutations Linked To Rare Metabolic Disease
    Columbus, Ohio Researchers have identified two mutations in a single gene as the cause of a rare disease, megaloblastic anemia.
    http://www.osu.edu/units/research/archive/cubn.htm
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    GENETIC MUTATIONS LINKED TO RARE METABOLIC DISEASE
    COLUMBUS, Ohio Researchers have identified two mutations in a single gene as the cause of a very rare metabolic disease that affects people in Finland, Norway and Saudi Arabia. It has taken nearly 40 years since the identification of the disease for researchers to trace its cause back to a faulty gene. An international team of a dozen scientists, including those from Ohio State University, reported their discovery in the latest issue of the journal Nature Genetics Called megaloblastic anemia 1, or Imerslund-Grasbeck syndrome after the two researchers who first described it, the defects prevent the normal absorption of vitamin B-12. If left untreated, the disease can be fatal. While serious, the syndrome is exceedingly rare only one person in a million may develop this disease. The disease has also been identified in patients from Israel, Turkey, Kuwait and the United States as well.

    6. LabCorp Megaloblastic Anemia
    will exacerbate the development of folate defi. ciency. megaloblastic anemia in alcoholics is most always due to fo-
    http://www.labcorp.com/cme/CME_Megaloblastic_Anemia_Journal_Article_0608.pdf

    7. MEDLINEplus Medical Encyclopedia: Megaloblastic Anemia - View Of Red Blood Cells
    megaloblastic anemia view of red blood cells. This picture shows large, dense,oversized, red blood cells (RBCs) that are seen in megaloblastic anemia.
    http://www.nlm.nih.gov/medlineplus/ency/imagepages/1214.htm
    Skip navigation
    Medical Encyclopedia
    Megaloblastic anemia - view of red blood cells This picture shows large, dense, oversized, red blood cells (RBCs) that are seen in megaloblastic anemia. Megaloblastic anemia can occur when there is a deficiency of vitamin B-12.
    Health Topics
    Drug Information Encyclopedia Dictionary ... National Institutes of Health
    Page last updated: 10 January 2003

    8. RCD - MEGALOBLASTIC ANEMIA
    megaloblastic anemia The normal proliferation of cells depends on adequate folate and vitamin B12. Folate is necessary for efficient thymidilate synthesis and production of DNA. B12 is needed to successfully incorporate circulating folic acid into
    http://www.med.virginia.edu/medicine/clinical/pathology/educ/innes/text/rcd/mega
    Megaloblastic Anemia The normal proliferation of cells depends on adequate folate and vitamin B12. Folate is necessary for efficient thymidilate synthesis and production of DNA. is needed to successfully incorporate circulating folic acid into developing RBCs; retaining the folate in the RBC. Review the metabolic mechanisms of B12 and folate (See Normal Hematopoiesis-B12 and Folate Metabolism) Pyrimidines: thymine, cytosine, and uracil
    Purines: adenine and guanine Lack of folate or B12 leads to decreased dTTP synthesis, resulting in a slowing of DNA synthesis. The role of folate is illustrated at right. The mechanism by which B12 leads to decreased DNA synthesis is unclear. Two likely explanations follow.
    • Methylfolate "trap" hypothesis . Lack of cobalamin slows the methyltransferase reaction resulting in increased N5-methyl FH4. Thus N5-methyl FH4 is "trapped" or unable to be metabolized to FH4. N5-methyl FH4 can convert to N5, 10-methylene FH4, but poorly without new FH4 other forms of folate diminish leading to slowed synthesis of dTMP.
      Formate "starvation" hypothesis . Lack of cobalamine slows the methyltransferase reaction deceasing methionine production and in turn depressing formate generation.
    A deficiency of either vitamin Bl2 or folic acid results in megaloblastic erythroid cells-

    9. Megaloblastic Anemia
    megaloblastic anemia. Causes, incidence, and risk factors Deficiencies of VitaminB12 and folic acid are the most common causes of megaloblastic anemia.
    http://www.umm.edu/ency/article/000567.htm
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    Megaloblastic anemia
    Overview Symptoms Treatment Prevention Definition: Megaloblastic anemia is a blood disorder characterized by anemia, with red blood cells that are larger than normal, usually resulting from a deficiency of folic acid or Vitamin B-12
    Alternative Names: Anemia - megaloblastic
    Causes, incidence, and risk factors: Deficiencies of Vitamin B-12 and folic acid are the most common causes of megaloblastic anemia. Other causes are leukemia myelofibrosis multiple myeloma , certain hereditary disorders, drugs that affect DNA synthesis such as chemotherapy agents (methotrexate), alcohol, and other causes. Risk factors relate to the causes. (See also pernicious anemia
    Megaloblastic anemia - view of red blood cells
    Hypersegmented PMN (Close-up) Blood cells Review Date: 10/8/2001
    Reviewed By: Rebecca Elstrom, M.D., University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network.
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    10. Hematopathology
    CBC here shows a markedly increased MCV, typical for megaloblastic anemia. The MCV can be mildly increased in persons
    http://www-medlib.med.utah.edu/WebPath/HEMEHTML/HEME025.html
    The CBC here shows a markedly increased MCV, typical for megaloblastic anemia. The MCV can be mildly increased in persons recovering from blood loss or hemolytic anemia, because the newly released RBC's, the reticulocytes, are increased in size over normal RBC's, which decrease in size slightly with aging.

    11. EMedicine - Megaloblastic Anemia : Article By Paul Schick, MD
    megaloblastic anemia megaloblastic anemias are a heterogeneous group of disordersthat share common morphologic characteristics. megaloblastic anemia.
    http://www.emedicine.com/MED/topic1420.htm
    (advertisement) Home Specialties CME PDA ... Patient Education Articles Images CME Patient Education Advanced Search Link to this site Back to: eMedicine Specialties Medicine, Ob/Gyn, Psychiatry, and Surgery Hematology
    Megaloblastic Anemia
    Last Updated: November 14, 2002 Rate this Article Email to a Colleague Synonyms and related keywords: blood disorder, megaloblastosis, cobalamin deficiency, vitamin B-12 deficiency, folate deficiency, pernicious anemia, PA, cobalamin neuropathy, ineffective erythropoiesis, food-cobalamin malabsorption, gastrectomy, Zollinger-Ellison syndrome, ZES, ileal resection, regional ileitis, intestinal lymphoma, Diphyllobothrium latum, D latum, fish tapeworm, blind loop syndrome, nitrous oxide exposure, NO exposure, surgical intestinal resection, amyloidosis, Whipple disease, scleroderma, psoriasis, exfoliative dermatitis, pregnancy, drug reactions, chemotherapy AUTHOR INFORMATION Section 1 of 10 Author Information Introduction Clinical Differentials ... Bibliography
    Author: Paul Schick, MD

    12. EMedicine - Anemia, Megaloblastic : Article By James L Harper, MD
    Anemia, Megaloblastic megaloblastic anemia is an uncommon problem in childhoodmost frequently associated with vitamin deficiency or gastrointestinal disease
    http://www.emedicine.com/ped/topic2575.htm
    (advertisement) Home Specialties CME PDA ... Patient Education Articles Images CME Patient Education Advanced Search Link to this site Back to: eMedicine Specialties Pediatrics Hematology
    Anemia, Megaloblastic
    Last Updated: March 1, 2002 Rate this Article Email to a Colleague AUTHOR INFORMATION Section 1 of 10 Author Information Introduction Clinical Differentials ... Bibliography
    Author: James L Harper, MD , Director of Nebraska Regional Hemophilia Treatment Center, Associate Professor, Department of Pediatrics, University of Nebraska Medical Center James L Harper, MD, is a member of the following medical societies: American Academy of Pediatrics American Medical Association American Society of Hematology , and Nebraska Medical Association Editor(s): Sharada A Sarnaik, MD , Director of Sickle Cell Program, Professor, Department of Pediatrics, Children's Hospital of Michigan and Wayne State University; Robert Konop, PharmD , Clinical Assistant Professor, Department of Pharmacy, Section of Clinical Pharmacology, University of Minnesota; Steven K Bergstrom, MD

    13. Megaloblastic Anemia (vitamin B12 Deficiency)
    next up previous Next Case 1 Up Atlas of Hematology Previous Irondeficiency anemia. megaloblastic anemia (vitamin B12 deficiency).
    http://pathy.med.nagoya-u.ac.jp/atlas/doc/node106.html

    14. 1Up Health > Megaloblastic Anemia > Causes, Incidence, And Risk Factors Of Megal
    Comprehesive information on megaloblastic anemia (Anemia megaloblastic). Megaloblasticanemia Causes, Incidence, and Risk Factors. Alternative names
    http://www.1uphealth.com/health/megaloblastic_anemia_info.html
    1Up Health Megaloblastic anemia Alternative Medicine Clinical Trials ... Health Topics A-Z Search 1Up Health Megaloblastic anemia Information Megaloblastic anemia Causes, Incidence, and Risk Factors Alternative names : Anemia - megaloblastic Definition : Megaloblastic anemia is a blood disorder characterized by anemia, with red blood cells that are larger than normal, usually resulting from a deficiency of folic acid or Vitamin B-12
    Causes, Incidence, and Risk Factors
    Deficiencies of Vitamin B-12 and folic acid are the most common causes of megaloblastic anemia. Other causes are leukemia myelofibrosis multiple myeloma , certain hereditary disorders, drugs that affect DNA synthesis such as chemotherapy agents (methotrexate), alcohol, and other causes. Risk factors relate to the causes. (See also pernicious anemia
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    15. 1Up Health > Megaloblastic Anemia (Anemia - Megaloblastic) Information
    Comprehesive information on megaloblastic anemia (Anemia megaloblastic). 1UpHealth Diseases Conditions megaloblastic anemia.
    http://www.1uphealth.com/health/megaloblastic_anemia.html
    1Up Health Alternative Medicine Clinical Trials Health News ... Health Topics A-Z Search 1Up Health Megaloblastic anemia Information Guide Alternative names : Anemia - megaloblastic Definition : Megaloblastic anemia is a blood disorder characterized by anemia, with red blood cells that are larger than normal, usually resulting from a deficiency of folic acid or Vitamin B-12
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    16. Health Ency.: Disease: Megaloblastic Anemia
    megaloblastic anemia See images. Causes and Risks. Deficiencies of VitaminB12 and folic acid are the most common causes of megaloblastic anemia.
    http://www.accessatlanta.com/shared/health/adam/ency/article/000567.html
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    Ency. home Disease M Megaloblastic anemia See images Overview Symptoms Treatment ... Prevention Alternative names: Anemia - megaloblastic Definition: Megaloblastic anemia is a blood disorder characterized by anemia, with red blood cells that are larger than normal, usually resulting from a deficiency of folic acid or Vitamin B-12 Causes and Risks Deficiencies of Vitamin B-12 and folic acid are the most common causes of megaloblastic anemia. Other causes are leukemia myelofibrosis multiple myeloma , certain hereditary disorders, drugs that affect DNA synthesis such as chemotherapy agents (methotrexate), alcohol, and other causes. Risk factors relate to the causes. (See also pernicious anemia Ency. home Disease M Please read this Important notice
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    17. Health Ency.: Disease: Megaloblastic Anemia
    megaloblastic anemia See images. Alternative names Anemia megaloblastic.Treatment. The objective of treatment is to determine the
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    Ency. home Disease M Megaloblastic anemia See images Overview Symptoms Treatment ... Prevention Alternative names: Anemia - megaloblastic Treatment The objective of treatment is to determine the cause of the anemia , and the treatment depends upon the cause. Anemias related to vitamin deficiencies are discussed separately. Prognosis The outcome is expected to be good with treatment. Complications Complications vary with the underlying cause. Call Your Health Care Provider If: Call for an appointment with your health care provider if symptoms develop. Ency. home Disease M Please read this Important notice
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    18. ThirdAge - Adam - Megaloblastic Anemia
    megaloblastic anemia. Definition Deficiencies of Vitamin B12 andfolic acid are the most common causes of megaloblastic anemia.
    http://www.thirdage.com/health/adam/ency/article/000567.htm
    document.write(''); document.write(''); document.write('<'); document.write('/SCRIPT>'); document.write(''); document.write(''); document.write('<'); document.write('/A>'); document.write('<'); document.write('/NOSCRIPT>'); document.write('<'); document.write('/IFRAME>'); Activities Computers Family Tree Health ... Prevention
    Megaloblastic anemia
    Definition: Megaloblastic anemia is a blood disorder characterized by anemia, with red blood cells that are larger than normal, usually resulting from a deficiency of folic acid or Vitamin B-12
    Alternative Names: Anemia - megaloblastic
    Causes, incidence, and risk factors: Deficiencies of Vitamin B-12 and folic acid are the most common causes of megaloblastic anemia. Other causes are leukemia myelofibrosis multiple myeloma , certain hereditary disorders, drugs that affect DNA synthesis such as chemotherapy agents (methotrexate), alcohol, and other causes. Risk factors relate to the causes. (See also pernicious anemia
    Megaloblastic anemia - view of red blood cells
    Hypersegmented PMN (Close-up) Blood cells
    Review Date: 10/8/2001
    Reviewed By: Rebecca Elstrom, M.D., University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network.

    19. ThirdAge - Adam - Megaloblastic Anemia - View Of Red Blood Cells
    back. This picture shows large, dense, oversized, red blood cells(RBCs) that are seen in megaloblastic anemia. megaloblastic anemia
    http://www.thirdage.com/health/adam/imagepages/1214.htm
    document.write(''); document.write(''); document.write('<'); document.write('/SCRIPT>'); document.write(''); document.write(''); document.write('<'); document.write('/A>'); document.write('<'); document.write('/NOSCRIPT>'); document.write('<'); document.write('/IFRAME>'); Activities Computers Family Tree Health ... Travel
    This picture shows large, dense, oversized, red blood cells (RBCs) that are seen in megaloblastic anemia. Megaloblastic anemia can occur when there is a deficiency of vitamin B-12.
    Review Date: 1/1/1997
    Reviewed By: Mosby Publishing Company
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    20. Megaloblastic Anemia
    Return to Hematopathology Laboratory Overview PreviousSlide Next Slide megaloblastic anemia.
    http://www.som.tulane.edu/classware/pathology/medical_pathology/New_for_98/Hemat
    Return to Hematopathology Laboratory Overview Previous Slide Next Slide
    Megaloblastic Anemia

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