by. Ana Sirley Calderon Flores. on 11 November Comments (0). Please log in to add your comment. Report abuse. Transcript of ANEMIA MACROCITICA. Megaloblastosis can be associated with severe anemia and pancytopenia, gastrointestinal dysfunction and glossitis, personality changes. Macrocytosis without anemia may be a normal variant and is only noted as a result of repeated peripheral RBC indices in the absence of any known or existing.

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Am J Med ; This time-honored method remains an acceptable form of treatment for all causes of vitamin B12 deficiency, particularly when cognitive impairment or neurologic disease is present.

Megaloblastic anemia Pernicious anemia.

Megaloblastic anemia

Esprue Tropical y No Tropical. Curr Opin Gastroenterol ; Bone Marrow Examination Macrocytosis associated with a megaloblastic marrow is usually accompanied by anemia due to ineffective erythropoiesis. Laboratory diagnosis mcrocitica vitamin B12 and folate deficiency: Storage of blood and the mean corpuscular volume.

Its serum concentration can be used to measure the amount of vitamin B12 attached to the binding protein transcobalamin II. Clin Lab Haematol ; Macrocytosis without anemia may be a normal variant and is only noted as a result of repeated peripheral RBC indices in the absence of any known or existing clinical problems. The erythroblasts become large, oval shaped and contain a characteristic immature, lacy nucleus. A measurement of methylmalonic acid methylmalonate can provide an indirect method for partially differentiating Vitamin B 12 and folate deficiencies.

This constellation of events eventually leads to pernicious anemia and requires prompt intervention with exogenous vitamin B12 preparations. Macrocytic anemia can usually be divided into two categories, megaloblastic and nonmegaloblastic, based on the examination of the bone marrow. Megaloblastic anemia not due to hypovitaminosis may be caused by antimetabolites that poison DNA production directly, such as some chemotherapeutic or antimicrobial agents for example azathioprine or trimethoprim.


This article has been corrected. Megaloblastic anemia has a rather slow onset, especially when compared to that of other anemias. Gross S, Roath S, eds. In these instances the peripheral blood smear may show a mixed population of microcytic and macrocytic RBCs with an elevated distribution width.

Copper deficiency resulting from an excess of zinc from unusually high oral consumption of zinc-containing denture-fixation creams has been found to be a cause.

Language Portal of Canada Access a collection of Canadian resources on all aspects of English and French, including quizzes. Additionally, the reticulocyte maturation parameters performed on the peripheral blood may also be helpful to differentiate megaloblastic from nonmegaloblastic causes of the macrocytosis.

Access a collection of Canadian resources macroocitica all aspects of English and French, including quizzes. Pages containing links to subscription-only content Articles needing additional medical references from September All macrocitiac needing additional references Articles requiring reliable medical sources Infobox medical condition All articles with unsourced statements Articles with unsourced statements from July Articles with unsourced statements from December Macrocytosis due to vitamin B12 or folate deficiency is a direct result of ineffective or dysplastic erythropoiesis.

Patients with macroditica who are not znemia and have no other abnormalities noted on the peripheral blood smear do not usually need a bone marrow examination. These abnormalities are most evident in the erythroid precursors with large megaloblastic erythroblasts present in increased numbers throughout the marrow. Inflamm Bowel Dis ; 9: Drugs that may induce macrocytosis.

Postgrad Med J ; These important vitamins and cofactors are required for normal maturation of all cells.

The spectrum of etiologies associated with macrocytic anemia includes nutritional deficiencies e. Normal levels of both methylmalonic acid and total homocysteine rule out clinically significant cobalamin deficiency with virtual certainty. Etiology and diagnostic evaluation of macrocytosis.


A Marked macro-ovalocytosis MCV fl in the peripheral blood smear of a patient with vitamin B12 deficiency. Utility of reticulocyte maturation parameters in the differential diagnosis of macrocytic anemias.

In folate deficiency patients, serum homocysteine levels are markedly increased, while serum MMA levels are not elevated. Folic acid deficiency in the United States is extremely rare because of the fortification of foods.

ANEMIA MACROCITICA by Ana Sirley Calderon Flores on Prezi

Because of the limitations of measuring serum folate, RBC folate levels have been advocated as a more reliable source of measuring tissue stores of folate. An advantage of the Schilling test was that it often included Vitamin B 12 with intrinsic factor.

Reticulocyte Count A reticulocyte count should be obtained if there is evidence of hemolysis on the peripheral smear, i. A reticulocyte count should be obtained if there ajemia evidence of hemolysis on the peripheral smear, i.

Harvard University Press; This form of cobalamin remains in the tissues longer than the cyanocobalamin forms and can, therefore, be given less frequently. Megaloblastoid megaloblastic-like abnormalities of the marrow are frequently seen in other hematologic disorders not associated with vitamin B12 or folate deficiency, e.

Existen tres picos de mayor prevalencia: However, the metabolism of L-methylmalonyl CoA to succinyl CoA, an enzymatic pathway involved in oxidative phosphorylation reactions within the cell, only requires vitamin B Holotranscobalamin as an indicator of dietary vitamin B12 deficiency.