2. Macrocytic anaemia Flashcards
How common is it?
2-4% prevalence
Who does it affect?
More common in elderly patients
What causes it?
Micro = iron deficiency, Hb disorders, chronic disease Normo = anaemia of chronic disease / inflammatory Macro = B12, folate deficiency, marrow damage, haemolysis
What risk factors are there?
Increasing age
Having certain autoimmune conditions eg hypothyroidism
How does it present?
Symptoms of anaemia
B12 = mouth ulcers, pale yellow tongue, paraesthesia, disturbed vision, irritability, depression
Folate = diarrhoea, reduced taste, muscle weakness
What signs may the patient have on examination?
Non-specific anaemia findings
Neurological deficits
Underlying disease stigmata (jaundice, glossitis, hepatosplenomegaly)
What other conditions might present similarly?
MDS Haemolytic anaemia HIV infection Hypothyroidism Alcoholism
How would you investigate?
FBC (LFT, TFT)
Peripheral blood smear
Reticulocyte count
What treatments are there?
Oral B12 / folate supplements
Altered diet
Treat underlying cause
What complications are there?
Adenocarcinoma (B12)
Subacute neurodegeneration
Psychiatric disturbances
