Megaloblastic Anemia Questions & Answers

Updated: Jul 17, 2021
  • Author: Srikanth Nagalla, MD, MS, FACP; Chief Editor: Emmanuel C Besa, MD  more...
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Questions & Answers

Overview

What is megaloblastic anemia?

What is the pathophysiology of megaloblastic anemia?

What are the roles of vitamin B-12 (cobalamin) and folate in the pathogenesis of megaloblastic anemia?

What theories have been developed for the genesis of cobalamin neuropathy relative to megaloblastic anemia?

What is the role of cobalamin uptake in the pathogenesis of megaloblastic anemia?

What is the role of cobalamin and folate storage in the pathogenesis of megaloblastic anemia?

What is the role of the enterohepatic cycle of cobalamin in the pathogenesis of megaloblastic anemia?

What is the role of folate uptake in the pathogenesis of megaloblastic anemia?

What is the role of cobalamin deficiency in the etiology of megaloblastic anemia?

What is the role of folate deficiency in the etiology of megaloblastic anemia?

What causes megaloblastic anemia in patients with HIV infection or myelodysplastic disorders?

What is the prevalence of megaloblastic anemia in the US?

What is the global prevalence of megaloblastic anemia?

Which patient groups are at highest risk for megaloblastic anemia?

What is the prognosis of megaloblastic anemia?

Presentation

Which clinical history findings are characteristic of megaloblastic anemia?

Which clinical history findings are characteristic of cobalamin deficiency in megaloblastic anemia?

Which clinical history findings are characteristic of folate deficiency in megaloblastic anemia?

Which physical findings are characteristic of megaloblastic anemia?

DDX

Which conditions should be included in the differential diagnoses of megaloblastic anemia?

What are the differential diagnoses for Megaloblastic Anemia?

Workup

Which studies are performed in the workup of megaloblastic anemia?

Which studies are performed in the initial workup of megaloblastic anemia?

What is the role of peripheral smear morphology in the diagnosis of megaloblastic anemia?

What is the role of bone marrow aspiration in the diagnosis of megaloblastic anemia?

Which serum B-12 (cobalamin) level findings are characteristic of megaloblastic anemia?

Which serum folate level findings are characteristic of megaloblastic anemia?

Which red blood cell (RBC) folate level findings are characteristic of megaloblastic anemia?

What is the role of serum homocysteine and methylmalonic acid (MMA) measurement in the evaluation of megaloblastic anemia?

What is the role of intrinsic factor (IF) antibody testing in the diagnosis of megaloblastic anemia?

What is the role of Schilling test in the diagnosis of megaloblastic anemia?

When is a cobalamin therapy given to confirm the diagnosis of megaloblastic anemia?

What is the role of iron studies in the diagnosis of megaloblastic anemia?

What is the role of imaging in the diagnosis of megaloblastic anemia?

Which tests should be considered in patients with cobalamin deficiency in megaloblastic anemia?

Which tests should be considered in patients with folate deficiency in megaloblastic anemia?

Treatment

How is megaloblastic anemia treated?

What is the role of cobalamin therapy in the treatment of megaloblastic anemia?

How is cobalamin therapy administered for the treatment of megaloblastic anemia?

What is the role of folate therapy in the treatment of megaloblastic anemia?

How is response to therapy for megaloblastic anemia monitored?

How are the comorbidities of megaloblastic anemia treated?

Which dietary modifications are used in the treatment of megaloblastic anemia?

Which specialist consultations are beneficial to patients with megaloblastic anemia?

What is included in long-term monitoring following the treatment of megaloblastic anemia?

Medications

What is the role of drug treatment for megaloblastic anemia?

Which medications in the drug class Electrolyte Supplements are used in the treatment of Megaloblastic Anemia?

Which medications in the drug class Vitamins are used in the treatment of Megaloblastic Anemia?