Waseem Iqbal, Hameeda Akhtar, Tariq Baqai, Mehmood Ur Rehman, Muzaffar M.
Morphological features in forty cases of Megaloblastic Anemia.
J Rawal Med Coll Jan ;7(1):39-42.
Background: To study the morphological features and associations in patients with megaloblastic anaemia with special reference to bone marrow. Method: The study was carried out in the Department of Haematology Islamic International Medical College and Railway Hospital, Rawalpindi. Patients with anemia having macrocytosis in the peripheral blood, were subjected to bone marrow examination. Complete blood counts, reticulocyte count and RBC morphology were performed in every case.Results: Forty cases showed megaloblastic change in the marrow. Out of these, nine patients had concomitant iron deficiency (mixed deficiency). Apart from macrocytosis, pancytopaenia / bicytopaenia, and neutrophilic hypersegmentation were other important findings in the peripheral blood. In the bone marrow megaloblastic change, mainly of moderate to severe intensity was observed. Dyserythropoiesis and haemophagocytosis were other significant findings contributing towards severity of anemia and decreased cell counts in the peripheral blood. Conclusions: Megaloblastic anaemia is the most common cause of pancytopaenia / bicytopaenia seen in the peripheral blood. Dyserythropoiesis and haemophagocytosis (mainly erythrophagocytosis) are significant bone marrow findings. Their increased intensity coincides with increased severity of megaloblastosis contributing towards depression of blood cells with fall in haemoglobin and platelet count in the peripheral blood. Co-existing iron deficiency (mixed deficiency) may mask or overshadow the characteristic peripheral blood and bone marrow morphological changes seen in megaloblastic anaemia.
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