Varied Clinico-haematological Presentation of Patients of Megaloblastic Anaemia with Deficiency of Vitamin B12 and Folic Acid in a Tertiary Care Center of Northern India

• Main Authors: Amreen Brown, Nishi Tandon, Syed Riaz Mehdi, Zeba Siddiqui
• Format: Article
• Language: English
• Published: JCDR Research and Publications Private Limited 2017-12-01
• Series: Journal of Clinical and Diagnostic Research
• Subjects: bone marrow; folic acid deficiency macrocytosis; vitamin b12 deficiency
• Online Access: https://jcdr.net/articles/PDF/10937/30253_CE(RA1)_F(T)_PF1(AA_GG)_PFA(MJ_AP)_PFA2(MJ_AP)_PB(MJ_GG).pdf

Introduction: Megaloblastic anaemia is caused by vitamin B12 and/or folic acid deficiency. Clinically megaloblastic anaemia may present as a continuum of asymptomatic metabolic abnormalities ranging to life-threatening clinical syndrome. Patients with megaloblastic anaemia have a risk of developing many complications. Aim: The aim of present study was to evaluate the varied clinicohaematological presentation of patients of megaloblastic anaemia associated with deficiency of vitamin B12 and folic acid. Materials and Methods: This cross-sectional study was carried out in the Department of Pathology, Era’s Lucknow Medical College and Hospital, Lucknow, Uttar Pradesh, India, over a period of 18 months. We studied 90 cases which were grouped as follows: Group A: no deficiency; Group B: vitamin B12 deficiency; Group C: folic acid deficiency; Group D: combined deficiency. Complete blood count was done using Sysmex XS800i. Vitamin B12 and folic acid assay was done using Enzyme Linked Immunosorbent Assay (ELISA). Bone marrow aspiration was also done. Results: Out of 90 patients, maximum (n=42; 46.7%) had vitamin B12 deficiency. In all the four groups, weakness and fatigue were the most common complaints. All the cases had pallor. Icterus, tingling, numbness and murmurs were relatively rare. All the fourteen cases in which bone marrow examination was carried out had erythroid hyperplasia and megaloblastic reaction. Conclusion: On the basis of above findings, it was concluded that there is a significant difference in the clinical presentation of patients of megaloblastic anaemia with vitamin B12 and folic acid deficiency. However, not very significant difference has been noticed in the haematological parameters. Thus, clinical and haematological profile both should be thoroughly assessed to differentiate between vitamin B12 and folic acid deficiency.