Tuesday, March 9, 2010

Megaloblastic anemia due to folate deficiency

Megaloblastic anemia due to folate deficiency - Chronic

Definition  

A megaloblastic anemia caused by a deficiency in folate that affects erythropoiesis


 

Medical History  

* Folate deficiency anemia due to dietary causes

* Pregnancy, Third Trimester

* Hemolytic anemia [Hemolytic anemia - Chronic]

* Alcohol Abuse

* Anticonvulsant use

* Sulfasalazine use

* Methotrexate use

* Trimethoprim/Sulfamethoxazole use

* Renal dialysis


 

Findings  

* Dyspnea - Chronic

* Sinus tachycardia

* Diarrhea

* Fatigue

* Glossitis

* Irritability

* Jaundice

* Loss of appetite

* Neuropathy

* Pallor

* Weight loss


 

Tests  


 

All patients with suspected folate deficiency anemia should have a CBC with WBC differential to aid in diagnosis.  

* Complete blood count with white cell differential, manual


 

Anemia  

* Peripheral blood smear examination, light microscopy: Blood smear examination is indicated in the initial evaluation of suspected or unexplained anemia .


 

Erythrocyte mean corpuscular volume will be above 100 in patients with megaloblastic anemia due to folate deficiency.  

* Erythrocyte mean corpuscular volume determination


 

RBC folate levels are more sensitive in determining a patient's folate stores than is a serum folate measurement in patients with folate deficiency megaloblastic anemia. RBC folate levels below 200 ng/mL are diagnostic of megaloblastic anemia due to folate deficiency. Serum folate is usually be correspondingly low (under 2).  

* Folic acid measurement, RBC


 

Screening for iron deficiency anemia  

* Measurement of total hemoglobin concentration: Two Hgb values below the accepted threshold are presumptive for iron-deficiency anemia. The diagnosis can be confirmed if hgb values rise to 1 g/dL or greater after 4 weeks of iron supplementation therapy .


 

Serum folate levels may be checked but are less specific and sensitive for folate deficiency than is a RBC folate level.  

* Folic acid measurement, serum


 

Suspected anemia  

* Hematocrit determination: Very mild anemias are associated with few or no clinical signs or symptoms; therefore, a mild anemia usually is first detected from a screening measurement of Hgb or HCT.


 

Suspected or known anemia  

* Reticulocyte count: The reticulocyte count is essential for differentiating between anemias arising from nonfunctional versus functional bone marrow .


 

Suspected vitamin B12 (cobalamin) deficiency secondary to pernicous anemia  

* Serum vitamin B12 measurement: Serum cobalamin levels below 74 pmol/L indicate a probable cobalamin deficiency .


 

Differential Diagnosis  

* ETHANOL

* Disease of liver

* Hypothyroidism - Chronic

* Megaloblastic anemia due to chronic hemolytic anemia

* Megaloblastic anemia due to dietary causes

* Celiac disease - Chronic

* Anemia of pregnancy

* METHOTREXATE AND RELATED AGENTS

* AIDS ANTIVIRAL NUCLEOSIDES

* AIDS ANTIVIRAL PROTEASE INHIBITORS

* Megaloblastic anemia due to increased requirements

* Megaloblastic anemia due to disease of small intestine

* Megaloblastic anemia due to vitamin B12 deficiency - Chronic

* Multiple myeloma - Chronic


 

Treatment  


 

Drug Therapy  


 

Anemia of pregnancy  


 

FOLIC ACID  

All pregnant women: 400 mcg orally once daily; initiate therapy before conception


 


 

Anemic pregnant women on anti-epileptic drugs, proguanil, maloprim, or with a previous baby with a neural tube defect  


 

FOLIC ACID  

Pregnant women on anti-epileptic drugs, proguanil, maloprim, or with a previous baby with a neural tube defect: 5 mg orally once daily


 


 

Folate deficiency megaloblastic anemia  


 

FOLIC ACID  

Adults: 1 to 5 mg orally daily for 4 months minimum

1 comment:

  1. I''m Charlotte Johnson,65  years old, Here in Edmonton, Canada. With the new herbal mix medicine I purchased from Dr James herbal mix medicine West Africa  was my only way to get rid of my Alzheimer's, the herbal  mix medicine effectively reversed my condition and alleviate all symptoms.  I was initially very hesitant to discuss my Alzheimer but I just hope it can still help someone. I feel this will be very important information for all Alzheimer patients, because the most violent element in society today is ignorance. Be it any condition, a healthy diet and natural herbs and roots medicine from Dr. James is the road to fast recovery. I had suffered Alzheimer for many years, I fought for proper medical recommendation, care  and all form of humane treatment with little improvement I went through many sleepless nights and periods of intense grief, as do most families. I was recommended by a friend to use Dr. James herbal mix medicine for my Alzheimer with high hope and assurance. I never doubted my friend but to contact Dr. James. And purchased His herbal mix medicine which was effective and I finally feel my Alzheimer is gone with no more symptoms. He also told me that he cures diseases such as  Lungs diseases, kidney diseases, Warts, Bipolar disorder, Shingles,  HPV, ALS, CANCER, NEPHROTIC SYNDROME, HIV / AIDS, Herpes virus, Ovarian Cancer, Pancreatic cancers, bladder cancer, prostate cancer, Glaucoma., Cataracts, Macular degeneration, Cardiovascular disease, Autism. Enlarged prostate, Osteoporosis. Alzheimer's disease, psoriasis, Tach Diseases, Lupus, Backache, dementia, skin cancer,.testicular Cancer, Leukemia, HEPATITIS A, B, C, Contact  the great one on his email    greatcureman@gmail.com
    Info @ drjamesherbalmix@gmail.com

    ReplyDelete

SYSTEM BASED CLASSIFICATION OF DISEASES

SYSTEM BASED CLASSIFICATION OF DISEASES

Bone and Joint Diseases

  1. Gout and Hyperurecemia
  2. Osteoarthritis
  3. Rheumatoid Arthritis
  4. Acute coronary Syndroms

Cardiovascular Diseases

  1. Arrhymias
  2. Cardiopulmanary Resuscitation
  3. Heart Failure
  4. Hypertension
  5. Hyperlipidemia
  6. Ischemic Heart Diseases
  7. Shock
  8. Stroke
  9. Venous Thromboembolism

Dermatrologic Diseases

  1. Acne
  2. Psoriasis
  3. Skin Disorders and Cutaneous Drug Eruptions

Endocrine Diseases

  1. Cirrhosis
  2. Portal Hypertension

Gastrointestinal Diseases

  1. Irritable Bowel Syndrome
  2. Constipation
  3. Diarrhea
  4. Gastroesophagal Reflux Disease
  5. Hepatitis, Viral
    1. Hepatitis A
    2. Hepatitis B
    3. Hepatitis C
  6. Nausea and Vomiting
  7. Pancreatitis
  8. Peptic Ulcer disease

Gynecologic and Obstetric Diseases

  1. Contraception
  2. Hormone therapy

Hematologic Diseases

  1. Anemia
    1. Megaloblastic Anemia

i. Megaloblastic Anemia due to Folate Deficiency

ii. Megaloblastic Anemia due to Vitamine B12 Deficiency

    1. Sickle Cell anemia
    2. Hemolytic Anemia
    3. Iron Deficiency Anemia
    4. Aplastic Anemia
    5. Iron Deficiency Anemia

Infectious Diseases

  1. Central Nervous System infections
  2. Endocarditis
  3. Fungal infections, Invasive
  4. Gastrointestinal Infection
  5. HIV / AIDS
  6. Intra-Abdominal Infection
  7. Respiratory Tract infections, Lower
  8. Respiratory Tract infections, Upper
  9. Sepsis and Septic Shock
  10. Sexually transmited Diseases (STD)
  11. Skin and soft tissue infection
  12. Tuberculosis
  13. Urinary tract infection and prostatitis

Neurologic Diseases

  1. Epilepsy
  2. Headache
    1. Migraine
    2. Cluster Headache
  3. Pain management
  4. Parkinson’s Diseases
  5. Status epilepticus

Nutritional Diseases

  1. Enteral Nutrition
  2. Obesity
  3. Parentaral Nutrition

Onchologic Diseases

  1. Breast cancer
  2. Colorectal Cancer
  3. Lung cancer
  4. Lymphomas
  5. Prostate cancer
  6. Cervical Cancer
  7. Esophageal Cancer
  8. Gastric Cancer
  9. Head and Neck Cancer
  10. Lung Cancer
  11. Ovarian Cancer
  12. Pancreatic Cancer
  13. Primary bone Cancer
  14. Primary Brain cancer
  15. Testicular Cancer
  16. Thyroid Gland Cancer
  17. Urinar Bladder cancer
  18. Uterine Cancer

Ophtalmic Diseases

  1. Glaucoma

Psychiatric Diseases

  1. Alzhimer’s Diseases
  2. Anxiety Disease
  3. Bipolar Diseases
  4. Depressive diseases
  5. Schizophrenia
  6. Sleep Diseases
  7. Substance-Related Diseases

Renal Diseases

  1. Acid base Diseases
  2. Acute renal Failure
  3. Chronic Renal Failure
  4. Drug Dosing in renal insufficiency
  5. Electrolyte Homeostasis

Respiratory Diseases

  1. Allergic Rhinitis
  2. Asthma
  3. Chronic Obstructive Pulmonary Diseases

Urologic Diseases

  1. Benign Prostatic, Hyperplasia
  2. Erectile Dysfunction
  3. Urinary Incontinence