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    Introduction To Macrocytic

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    Salim Uddinkhan
    This document discusses macrocytic anemia, which is characterized by abnormally large red blood cells. There are two main types: megaloblastic anemia, caused by vitamin B12 or folate deficiency which results in abnormal nuclear maturation in developing red blood cells; and non-megaloblastic anemia, caused by other factors. Vitamin B12 is important for DNA synthesis and is obtained through animal products, while folate is also required for DNA synthesis and is found in plant-based foods. Laboratory tests for macrocytic anemia show large, oval red blood cells and abnormalities in the bone marrow and blood counts.

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    Introduction To Macrocytic

    Uploaded by

    Salim Uddinkhan
    12 views9 pages
    This document discusses macrocytic anemia, which is characterized by abnormally large red blood cells. There are two main types: megaloblastic anemia, caused by vitamin B12 or folate deficiency which results in abnormal nuclear maturation in developing red blood cells; and non-megaloblastic anemia, caused by other factors. Vitamin B12 is important for DNA synthesis and is obtained through animal products, while folate is also required for DNA synthesis and is found in plant-based foods. Laboratory tests for macrocytic anemia show large, oval red blood cells and abnormalities in the bone marrow and blood counts.

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    Macrocytic anemia and their cuases

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    Introduction to macrocytic-converted

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    This document discusses macrocytic anemia, which is characterized by abnormally large red blood cells. There are two main types: megaloblastic anemia, caused by vitamin B12 or folate deficiency which results in abnormal nuclear maturation in developing red blood cells; and non-megaloblastic anemia, caused by other factors. Vitamin B12 is important for DNA synthesis and is obtained through animal products, while folate is also required for DNA synthesis and is found in plant-based foods. Laboratory tests for macrocytic anemia show large, oval red blood cells and abnormalities in the bone marrow and blood counts.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    12 views9 pages

    Introduction To Macrocytic

    Uploaded by

    Salim Uddinkhan
    This document discusses macrocytic anemia, which is characterized by abnormally large red blood cells. There are two main types: megaloblastic anemia, caused by vitamin B12 or folate deficiency which results in abnormal nuclear maturation in developing red blood cells; and non-megaloblastic anemia, caused by other factors. Vitamin B12 is important for DNA synthesis and is obtained through animal products, while folate is also required for DNA synthesis and is found in plant-based foods. Laboratory tests for macrocytic anemia show large, oval red blood cells and abnormalities in the bone marrow and blood counts.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 9

    Introduction to macrocytic

    anaemia
    • In macrocytic anaemia the red cells are
    abnormally large (mean corpuscular volume,
    MCV > 98 fL). There are several causes but
    they can be broadly subdivided into
    megaloblastic and non - megaloblastic, based
    on the appearance of developing
    erythroblasts in the bone marrow.
    Megaloblastic anaemias
    • This is a group of anaemias in which the
    erythroblasts in the bone marrow show a
    characteristic abnormality – maturation of the
    nucleus being delayed relative to that of the
    cytoplasm. The underlying defect accounting for
    the asynchronous maturation of the nucleus is
    defective DNA synthesis and this is usually caused
    by deficiency of vitamin B 12 or folate. Less
    commonly, abnormalities of metabolism of these
    vitamins or other lesions in DNA synthesis may
    cause an identical haematological appearance.
    Vitamin B 12 ( B 12 , cobalamin)
    • This vitamin is synthesized in nature by
    microorganisms; animals acquire it by eating
    other animal foods, by internal production from
    intestinal bacteria (not in humans) or by eating
    bacterially con-taminated foods. The vitamin
    consists of a small group of compounds, the
    cobalamins, which have the same basic structure,
    with a cobalt atom at the centre of a corrin ring
    which is attached to a nucleotide portion. Th e
    vitamin is found in foods of animal origin such as
    liver, meat, fish and dairy produce but does not
    occur in fruit, cereals or vegetables.
    Causes of megaloblastic anaemia.

    • Vitamin B 12 deficiency
    • Folate deficiency
    • Abnormalities of vitamin B 12 or folate
    metabolism (e.g. transcobalamin deficiency,
    nitrous oxide, antifolate drugs) Other defects of
    DNA synthesis Congenital enzyme deficiencies
    (e.g. Orotic aciduria)
    • Acquired enzyme deficiencies (e.g. Alcohol,
    therapy with hydroxyurea, cytosine arabinoside)
    Folate
    • Folic (pteroylglutamic) acid is the parent
    compound of a large group of compounds, the
    folates, that are derived from it. Humans are
    unable to synthesize the folate structure and
    thus require preformed folate as a vitamin.
    Absorption, transport and function

    • Dietary folates are converted to methyl THF


    (which, like folic acid, contains only one
    glutamate moiety) during absorption through the
    upper small intestine. Once inside the cell they
    are converted to folate polyglutamates. Folate
    binding proteins are present on cell surfaces
    including the enterocyte and facilitate entry of
    reduced folates into cells. There is no specific
    plasma protein that enhances cellular folate
    uptake.
    Megaloblastic anaemia: peripheral blood film showing oval macrocytes
    Laboratory findings
    • The anaemia is macrocytic (MCV > 98 fL and often as high
    as 120 – 140 fL in severe cases) and the macrocytes are
    typically oval in shape. The reticulocyte count is low and
    the total white cell and platelet counts may be moderately
    reduced, especially in severely anaemic patients. A
    proportion of the neutrophils show hypersegmented nuclei
    (with six or more lobes). The bone marrow is usually
    hypercellular and the erythroblasts are large and show
    failure of nuclear maturation maintaining an open, fine,
    lacy primitive chromatin pattern but normal
    haemoglobinization. Giant and abnormally shaped
    metamyelocytes are characteristic. The serum
    unconjugated bilirubin and lactate dehydrogenase are
    raised as a result of marrow cell breakdown.

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