Etiopathogenesis, Clinical Features, and Management of Vitamin B12 and Folate Deficiency Anemia

Diagnosis and Laboratory Findings in Vitamin B12 Deficiency Anemia

Vitamin B12 deficiency anemia is a condition resulting from inadequate levels of Vitamin B12, leading to impaired DNA synthesis and ineffective erythropoiesis.

Etiopathogenesis

• Pernicious anemia (autoimmune destruction of parietal cells)
• Dietary deficiency (strict vegan diet)
• Malabsorption syndromes (Crohn’s disease, celiac disease)
• Gastric surgery (gastrectomy, bariatric procedures)

Clinical Features

• Fatigue, pallor, and dyspnea
• Neurological symptoms (paresthesia, ataxia, cognitive impairment)
• Glossitis and angular cheilitis

Diagnosis and Laboratory Findings

Diagnosis involves a combination of clinical presentation and laboratory investigations:

• Complete blood count (macrocytic anemia, elevated MCV)
• Peripheral blood smear (hypersegmented neutrophils)
• Serum Vitamin B12 levels (low concentration)
• Methylmalonic acid and homocysteine levels (elevated)
• Intrinsic factor antibody test (for pernicious anemia)

Management

• Vitamin B12 supplementation (oral or intramuscular)
• Dietary modifications (increase intake of meat, dairy, fortified foods)
• Treatment of underlying malabsorption disorders