Macrocytic anaemia Flashcards
Classes of macrocytic anaemias and give examples of causes of each
Megaloblastic: B12 deficiency, folate deficiency, hydroxycarbamide
Non-megaloblastic: liver disease, alcohol, reticulocytosis, myxoedema/hypothyroidism, myelodysplasia
Causes of B12 deficiency anaemia
Poor dietary intake (veganism) Pernicious anaemia Gastrectomy Terminal ileum resection Chron's Coeliacs
Clinical features of B12 deficiency anaemia
Glossitis Mild jaundice + pallor = lemon tinge Peripheral neuropathy Subacute combined degeneration of the spinal cord (symmetrical dorsal column loss, corticospinal tract loss) Depression
Antibodies present in B12 deficiency anaemia
Parietal cell antibodies in 90%
Intrinsic factor antibodies in 50% (more specific)
What’s associated with pernicious anaemia
B12 deficiency anaemia Vitiligo Addisons Thyroid disease Gastric adenocarcinoma
Treatment for B12 deficiency anaemia
Parenteral hydroxacobalamin for peripheral neuropathy or malabsorption
Oral cyanocobalamin for dietary
Causes of folate deficiency anaemia
Poor dietary intake Pregnancy Coeliac Haemolysis Malignancy Methotrexate Alcohol Phenytoin
Where is folate absorbed
Jejunum
Where is B12 absorbed
Terminal ileum
Treatment for folate deficiency anaemia
Treat underlying cause
Give folic acid OD for 4 months WITH B12 SUPPLEMENTS UNLESS B12 NORMAL (folate alone can precipitate SCAD)
What foods contain folate
Nuts
Liver
Green veg
Yeast
What foods contain B12
Meat
Fish
Dairy
