Megaloblastic anemia- Causes and Treatment

Megaloblastic anemia is a condition in which the bone marrow produces unusually large, structurally abnormal, immature red blood cells (megaloblasts). Bone marrow, the soft spongy material found inside certain bones, produces the main blood cells of the body -red cells, white cells, and platelets. Anemia is a condition characterized by the low levels of circulating, red blood cells. Red blood cells are released from the marrow into the bloodstream where they travel throughout the body delivering oxygen to tissue. A deficiency in healthy, fully-matured red blood cells can result in fatigue, paleness of the skin (pallor), lightheadedness and additional findings. Megaloblastic anemia has several different causes - deficiencies of either cobalamin (vitamin B12) or folate (vitamin B9) are the two most common causes. These vitamins play an essential role in the production of red blood cells.

Signs & Symptoms

In most cases, megaloblastic anemia develops slowly and affected individuals may remain without any apparent symptoms (asymptomatic) for many years. Symptoms common to anemia usually develop at some point and may include fatigue, paleness of the skin (pallor), shortness of breath, lightheadedness, dizziness and a fast or irregular heartbeat. The specific symptoms present in each individual can vary greatly.

Additional common symptoms include aches and pains, muscle weakness, and difficulty breathing (dyspnea). Individuals with megaloblastic anemia may also develop gastrointestinal abnormalities including diarrhea, nausea, and loss of appetite. Some affected individuals may develop a sore, reddened tongue. These abnormalities may result in unintended weight loss. Mild enlargement of the liver (hepatomegaly) and a slight yellowing of the skin or eyes (jaundice) may also occur.

Megaloblastic anemia resulting from cobalamin deficiency may also be associated with neurological symptoms.

Causes

The most common causes of megaloblastic anemia are deficiency of either cobalamin (vitamin B12) or folate (vitamin B9). These two vitamins serve as building blocks and are essential for the production of healthy cells such as the precursors to red blood cells. Without these essential vitamins, the creation (synthesis) of deoxyribonucleic acid (DNA), the genetic material found in all cells, is hampered.

Vitamin deficiency resulting in megaloblastic anemia may result from inadequate intake of cobalamin and folate in the diet, poor absorption of these vitamins by the intestines or improper utilization of these vitamins by the body. Folate deficiency may also result from conditions which use up or require excessive amounts of folate.

Standard Therapies

Treatment

The treatment of megaloblastic anemia depends upon the underlying cause of the disorder. Dietary insufficiency of cobalamin and folate can be treated with appropriate changes to the diet and the administration of supplements. In individuals who cannot absorb cobalamin or folate properly, life-long supplemental administration of these vitamins may be necessary. Prompt treatment of cobalamin deficiency is important because of the risk of neurological symptoms.

If underlying disorders (e.g., Crohn's disease, tropical sprue, celiac sprue, blind loop syndrome, inborn errors of metabolism) are the cause of these vitamin deficiencies, appropriate treatment for the specific disorder is required. Supplementation of either cobalamin or folate may also be required.

If medications are the cause of vitamin deficiency then use of the medication in question should be stopped or the dosage lowered.

Preventive (prophylactic) folate supplementation may be recommended for individuals who have higher-than-normal demands for folate such as pregnant women.

Journal of Food and Clinical Nutrition is a peer reviewed open access journal. Interested can submit their manuscript through online portal. Submit manuscript at https://www.pulsus.com/submissions/food-clinical-nutrition.html or through mail at foodclinnutri@eclinjournals.com. For membership contact:

Media contact:

Maegan Smith           

Managing Editor

Journal of Food and Clinical Nutrition 

Mail ID: clinicalnutrition@emedicalsci.org

Whatsapp no: + 1-504-608-2390