Etiology, pathogenesis, clinical features, and management of vitamin B12 and folate deficiency anemia
Etiology of vitamin B12 and folate deficiency anemia
Vitamin B12 and folate deficiencies cause megaloblastic anemia due to impaired DNA synthesis, leading to macrocytic red blood cells. Treatment involves supplementation and managing underlying causes.
Etiology, Pathogenesis, Clinical Features, and Management of Vitamin B12 and Folate Deficiency Anemia
Etiology of Vitamin B12 and Folate Deficiency Anemia
Vitamin B12 and folate are essential for DNA synthesis and red blood cell production. Deficiencies in these vitamins lead to megaloblastic anemia, characterized by impaired nuclear maturation of hematopoietic cells.
Causes of Vitamin B12 Deficiency
- Dietary Deficiency: Inadequate intake from animal products
- Malabsorption: Pernicious anemia, atrophic gastritis, Crohn’s disease
- Increased Demand: Pregnancy, chronic hemolysis
- Medications: Proton pump inhibitors, metformin
Causes of Folate Deficiency
- Dietary Deficiency: Insufficient intake of leafy greens, legumes
- Malabsorption: Celiac disease, tropical sprue
- Increased Demand: Pregnancy, hemolytic anemia
- Medications: Methotrexate, trimethoprim
Pathogenesis
Vitamin B12 and folate deficiencies lead to ineffective erythropoiesis, causing macrocytic anemia. The hallmark is megaloblastic changes in bone marrow cells, resulting in large, immature erythrocytes.
Clinical Features
Common symptoms include fatigue, pallor, glossitis, and neurological manifestations like paresthesia and cognitive impairment in vitamin B12 deficiency.
Management
- Vitamin B12 Deficiency: IM cyanocobalamin injections, oral supplements
- Folate Deficiency: Oral folic acid replacement
- Addressing Underlying Causes: Treat malabsorption conditions and dietary deficiencies
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