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Megaloblastic Anemia

Megaloblastic Anemia

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Megaloblastic Anemia

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  1. Megaloblastic Anemia Dr Rajaa Marouf

  2. Objectives • Body stores and daily requirements of vitamin B12 and folate • Absorption of vitamin B12 and folate from the gut • Causes of vitamin B12 and folate deficiency • Hematological consequences of vitamin B12 and folate deficiency • Neurological sequelae of vitamin B12 deficiency • Diagnosis and management of megaloblastic anemia • Diagnosis and management of Pernicious Anemia

  3. Requirements for Red Blood Cell Production • Erythropoeitin • Proteins, required for globin synthesis • Iron • Vitamin B12 and folic acid • Vitamin B6 • Vitamin C • Thyroid hormones, estrogens and androgens

  4. Vitamin B 12 and Folate

  5. Macrocytic anemia with hypersegmented neutrophil

  6. Macro-ovalocyte in megaloblastic anemia

  7. Macro-ovalocyte in megaloblastic anemia

  8. Megaloblastic Anemia – Bone Marrow

  9. Bone marrow - megaloblasts

  10. an intermediate of the citric acid cycle, porphyrin synthesis (Heme synthesis) Important for DNA synthesis, nervous tissue and fat metabolism in the liver

  11. Absorption and transport of vitamin B12

  12. Absorption and transport of vitamin B12

  13. B12 /

  14. Early graying of hair Blue eyes Pernicious Anemia (PA)

  15. Red beefy tongue Pernicious Anemia

  16. Vitiligo Pernicious Anemia

  17. PA Normal Gastric atrophy

  18. Atrophic Gastritis

  19. The patient was a 45 year old woman. She had a swollen tender tongue, parasthesias of both feet and hands, decreased proprioception and vibratory sensation, ataxia and leg weakness.

  20. Subacute Combined Degeneration of Spinal Cord