Clinico-aetiologic profile of macrocytic anemias with special reference to megaloblastic anemia

摘要

Purpose of study This study was conducted to study thernclinical and laboratory parameters in patients with macrocyticrnanemia and to determine the etiology of macrocyticrnanemia with special reference to megaloblastic anemia.rnMaterials and methods This study was a cross-sectionalrndescriptive study carried over a period of 18 months on 60rnadult patients (age ≥13 years) of macrocytic anemia. Macrocyticrnanemia was identifi ed when peripheral blood examinationrnshowed anemia with a mean red blood corpuscularrnvolume of >95 fl .rnResult The most common cause of macrocytic anemia wasrnmegaloblastic anemia (38.4%). The major causes of nonmegaloblasticrnmacrocytic anemia were primary bone marrowrndisorders (35%), liver diseases (15%) and hemolytic anemiarn(8.3%). There was a signifi cant male preponderance in thernstudy (65%). The megaloblastic anemias observed were duernto either vitamin Brn12rndefi ciency (78.3%) or combined Brn12rnand folate defi ciency (21.7%). A signifi cant proportion ofrnnon–vegetarians (73.9%) had megaloblastic anemia.rnPatients with an MCV of >110fl were more likely to havernmegaloblastic anemia (p value 0.0007). Three patientsrn(mean age 55 years) with a megaloblastic marrow did notrnrespond to vitamin replacement and were found to havernmyelodysplastic syndrome.rnConclusion Megaloblastic anemia due to Vitamin Brn12rnorrnfolate defi ciency remains the most important cause of macrocyticrnanemia. In settings with limited laboratory facilities,rna therapeutic trial of vitamins Brn12rnor folic acid is useful inrndetermining the specifi c vitamin defi ciency.