Salma Haq, Nasir Iqbal, Fatima Fayyaz, Tahira Tasneem.
Serum B12 and folate levels in patients with megaloblastic change in the bone marrow.
Biomedica Jan ;28(1):35-9.

Introduction: Vitamin B12 and folic acid are essential components of DNA synthesis in red cell precursors. Folic acid is directly involved and Vitamin B12 (methyl cobalamine) participates as a cofactor. A deficiency of Vitamin B12 causes the same symptoms as folic acid deficiency. Objective: The study was carried out to find the cause of megaloblastic anemia. Study design and settings: In this descriptive study, we evaluated clinical and morphological features of 80 consecutive patients with a megaloblastic change in bone marrow from 2008-2010. The study was carried out in the Hematology Laboratory, Services Institute of Medical Sciences, Lahore. Results: Eighty patients with a megaloblastic change in bone marrow were studied. There were 32 males (40%) and 48 females (60%). The most common clinical presentation was pallor and fatigue (67 patients, 84%). Out of the 80 patients, 50 (62.5%) were deficient in folic acid and 24 patients (30%) were Vitamin B12 deficient. 6 patients (7.5%) were Coomb’s positive, indicating Immunemediated Hemolytic Anemia as the cause of megaloblastic anemia. Conclusion: Folic acid deficiency was the most common cause of megaloblastic anemia (62.5%) in the given population. Vitamin B12 deficiency was the next most common cause (30%). 6 patients (7.5%) had normal levels of Vitamin B12 and Folic acid and were Coomb’s positive showing that Immune – mediated hemolytic anemia can also be a cause of megaloblastic change in the bone marrow.

PakMediNet -Pakistan's largest Database of Pakistani Medical Journals - http://www.pakmedinet.com