81. MIR Teaching File Case St002 megaloblastic anemia may be due to folic acid or B12 deficiency. There are three types of B12 deficiency (1st two of which are tested by Schilling tests) http://gamma.wustl.edu/st002te178.html

Case Author(s): David A. Hillier, M.D., Ph.D. and Jerold Wallis, M.D. , . Rating: #D3, #Q3 Diagnosis: Pernicious anemia Brief history: 40 year-old man with anemia. Images: Schilling test View main image(mm) in a separate image viewer Full history/Diagnosis is available below Diagnosis: Pernicious anemia Full history: 40 year-old man with anemia and low serum B-12 levels. Radiopharmaceutical: Schilling test, 4.0 uCi Co-58 cyanocobalamin, po; 0.5 uCi Co-57 cyanocobalamin-intrinsic factor complex, po; Separate 1 mg intramuscular injections of cyanocobalamin following tracer adminstration on day 1, and again the following morining. Findings: Poor absorption of free B12 (C0-58 labeled), with only 0.82% of the dose excreted in the urine (normal > 10%). Good absorption of B12 when bound to intrinsic factor (Co-57-IF), with 16.3% of the dose excreted into the urine. The ratio between these values is 19.9. If intrisic factor had not made a difference, this ratio would be close to 1. Discussion: Megaloblastic anemia may be due to folic acid or B12 deficiency. There are three types of B12 deficiency (1st two of which are tested by Schilling tests):

82. Megaloblastic Anemia - Glossary Entry - Genetics Home Reference Synonym(s). anemia, megaloblastic. Definition(s). A disorder characterized by the presence of anemia, abnormally large red blood cells (megalocytes or http://ghr.nlm.nih.gov/ghr/glossary/megaloblasticanemia

Home What's New Browse Handbook ... Search Glossary Glossary Glossary Sources Glossary A ... Y-Z Megaloblastic anemia Synonym(s) anemia, megaloblastic Definition(s) A disorder characterized by the presence of anemia, abnormally large red blood cells (megalocytes or macrocytes), and megaloblasts. Definition from: Unified Medical Language System (MeSH) at the National Library of Medicine An anemia (as pernicious anemia) characterized by the presence of megaloblasts in the circulating blood. Definition from: MedlinePlus at the National Library of Medicine Published: September 6, 2005 Contact NLM Customer Service Lister Hill National Center for Biomedical Communications ... Selection Criteria for Web Links Indicates a page outside Genetics Home Reference.

83. OMIM - THIAMINE-RESPONSIVE MEGALOBLASTIC ANEMIA SYNDROME; TRMA http://www.ncbi.nlm.nih.gov/entrez/dispomim.cgi?id=249270

84. Hematology And Blood Disorders - Megaloblastic (Pernicious) Anemia Megaloblastic (Pernicious) Anemia. What is megaloblastic (pernicious) anemia? megaloblastic anemia, also called pernicious anemia, is a type of anemia http://www.schneiderchildrenshospital.org/peds_html_fixed/peds/hematology/megalo

Hematology and Blood Disorders Megaloblastic (Pernicious) Anemia What is megaloblastic (pernicious) anemia? Megaloblastic anemia, also called pernicious anemia, is a type of anemia characterized by very large red blood cells. In addition to the cells being large, the inner contents of each cell are not completely developed. This malformation causes the bone marrow to produce fewer cells, and sometimes the cells die earlier than the 120-day life expectancy. Instead of being round or disc-shaped, the red blood cells can be oval. What causes megaloblastic (pernicious) anemia? There are many causes of megaloblastic anemia, but the most common source in children occurs from a vitamin deficiency of folic acid. Other sources of megaloblastic anemia include the following: digestive diseases Certain diseases of the lower digestive tract can lead to megaloblastic anemia. These include celiac disease, chronic infectious enteritis, and enteroenteric fistulas. malabsorption Inherited congenital folate malabsorption, a genetic problem in which infants cannot absorb folic acid in their intestines, can lead to megaloblastic anemia. This requires early intensive treatment to prevent long term problems such as mental retardation.

85. Anemia: How Food And Vitamins Can Help - Swedish Medical Center, Seattle, Washin megaloblastic anemia. This type of anemia is primarily associated with inadequate This is another form of megaloblastic anemia caused by the absence of http://www.swedish.org/16409.cfm

PDF Version Search Send-to-Friend Health Library Home ... Women's Health Anemia: How Food and Vitamins Can Help by Bethanne Black If you're feeling exhausted (despite lots of sleep), have decreased energy, and seem to be unusually pale, the culprit could be some form of anemia. Although iron-deficiency anemia is by far the most common form of anemia, there are other types. Here, we'll discuss three forms of anemia that are related to nutrition. More Than Just a Lack of Iron Anemia is any blood disorder in which the number and/or size of the red blood cells is altered. Red blood cells”with the help of iron-containing hemoglobin”move oxygen from your lungs to bodily tissues, so any change in the size or amount of these cells affects how oxygen is transported within your body. What Are the Symptoms of Anemia? "The symptoms of anemia are numerous and affect many organ systems in the body," says Susan M. Lark, MD, of Stanford University, a physician specializing in women's health. "Often the symptoms seem vague and misleading to women and their physicians." Symptoms of anemia include: Fatigue and dizziness General weakness Shortness of breath Paleness Loss of appetite Brittle and ridged nails The "Nutritional" Anemias Iron-Deficiency Anemia In the United States, 20% of women of childbearing age suffer from iron-deficiency anemia, compared with only 2% of men. It can be caused by the following:

86. Megaloblastic Anemia megaloblastic anemia. http://www.som.tulane.edu/classware/pathology/medical_pathology/New_for_98/Hemat

87. Nutritional Anemias Introduction to iron deficiency, megaloblastic anemia, and anemia of chronic In some cases of megaloblastic anemia, there is concomitant leucopenia and http://web2.airmail.net/uthman/nutritional_anemia/nutritional_anemia.html

Nutritional Anemias And Anemia of Chronic Disease Ed Uthman, MD Diplomate, American Board of Pathology This is a document in a five-part series on blood cells and anemia: 1. Blood cells and the CBC 2. Anemia: Pathophysiologic Consequences, Classification, and Clinical Investigation 3. Nutritional Anemias and Anemia of Chronic Disease 4. Hemolytic Anemias 5. Hemoglobinopathies and Thalassemias Updated 1 Nov 1998 I. Iron metabolism and iron deficiency anemia A. Iron and its metabolism The fourth most abundant element in the earth's crust, iron is only a trace element in biologic systems, making up only 0.004% of the body's mass. Yet it is an essential component or cofactor of numerous metabolic reactions. By weight, the great proportion of the body's iron is dedicated to its essential role as a structural component of hemoglobin. Hemoglobin without iron is totally useless (in fact, hemoglobin with Fe instead of the normal Fe is the ugly brown methemoglobin and is also worthless as an oxygen carrier). Without sufficient iron available to the rbc precursors, normal erythropoiesis cannot take place, and anemia develops. On the other hand, iron is a toxic substance. Too much iron accumulating in vital structures (especially the heart, pancreas, and liver) produces a potentially fatal condition, hemochromatosis . Clearly, iron, like oxygen, is another of the deleterious substances that evolution has led biologic systems into flirtation with.

88. Megaloblastic Anemia megaloblastic anemia is a blood disorder characterized by anemia, with red blood cells that are larger than normal, usually resulting from a deficiency of http://www.pennhealth.com/ency/article/000567.htm

Appointments Medical Services Health Information Find a Doctor Search: Search Encyclopedia: List of Topics Print This Page  Hematology Megaloblastic anemia Megaloblastic anemia - view of red blood cells Hypersegmented PMN (Close-up) Blood cells Definition: Megaloblastic anemia is a blood disorder characterized by anemia, with red blood cells that are larger than normal, usually resulting from a deficiency of folic acid or of vitamin B-12 Alternative Names: Anemia - megaloblastic Causes, incidence, and risk factors: Deficiencies of vitamin B-12 and folic acid are the most common causes of megaloblastic anemia. Other causes are leukemia, myelofibrosis multiple myeloma , certain hereditary disorders, drugs that affect DNA synthesis such as chemotherapy agents (methotrexate), alcohol, and other causes. Risk factors relate to the causes. (See also pernicious anemia Symptoms: Loss of appetite Diarrhea Tingling and numbness of hands and feet Pale skin color Tiredness Headaches Sore mouth and tongue Change in skin color Signs and tests: Examination of neurological signs may show abnormal reflexes, decreased position sense, and decreased vibration sense if related to vitamin B-12 deficiency.

89. What Is Anemia? Pernicious and megaloblastic anemia. This is caused by a deficiency in vitamin B12. Alcohol abuse or malnutrition causes megaloblastic anemia. http://ga.essortment.com/whatisanemia_rwgq.htm

What is anemia? What is anemia? There are many different types explained here, and what can be some of the causes and symptoms? Anemia is a term which is used for different disorders that are characterized by a deficiency of hemoglobin. Hemoglobin is what picks up oxygen in your lungs and carries it to all the cells throughout the body. That would then make anemia, oxygen starvation. Some signs of mild anemia might be: Weakness Fatigue Pallor Brittle/spoon shaped nails More severe cases: Shortness of Breath Fainting Cardiac arrhythmias Iron-Deficiency Anemia: This is the most common type of anemia in the United States. Massive or chronic most generally causes blood loss. This type of anemia is commonly found in surgery patients, accident victims, and people with bleeding ulcers or those with intestinal cancer. Woman with heavy menstrual periods is also at risk. Hemolytic Anemia: This type of anemia occurs when red blood cells are destroyed faster than normal. The cause for this one may be hereditary. Examples: Sickle-cell anemia Leukemia Abnormal spleen function Autoimmune disorders Severe hypertension Pernicious and Megaloblastic Anemia: This is caused by a deficiency in vitamin B12. B12 is necessary to make red blood cells. Pernicious, the most common of the two is due to an intestinal disorder, which prevents absorption of the vitamin. Alcohol abuse or malnutrition causes megaloblastic anemia.

90. Resource Library Find Information On Megaloblastic Anemia At Find information on megaloblastic anemia at MerckSource. Learn more about megaloblastic anemia, megaloblastic anemia is a blood disorder characterized by http://www.mercksource.com/pp/us/cns/cns_hl_adam.jspzQzpgzEzzSzppdocszSzuszSzcns

91. Free Online ICD9/ICD9CM Codes And Medical Dictionary Combined B12 and folatedeficiency anemia. Refractory megaloblastic anemia. 281.4 Protein-deficiency anemia. Amino-acid-deficiency anemia http://icd9cm.chrisendres.com/index.php?action=child&recordid=2015

92. The American Journal Of The Medical Sciences - Abstract: Volume 317(1) January 1 Results The most common cause of pancytopenia was megaloblastic anemia, Conclusions megaloblastic anemia, aplastic anemia, and AIDS are the most http://www.amjmedsci.com/pt/re/ajms/abstract.00000441-199901000-00004.htm

LWWOnline LOGIN eALERTS REGISTER ... Archive Pancytopenia in Zimbabwe. ARTICLE LINKS: Fulltext Pancytopenia in Zimbabwe. American Journal of the Medical Sciences. 317(1):22-32, January 1999. SAVAGE, DAVID G. MD *[//]; ALLEN, ROBERT H. MD ; GANGAIDZO, INNOCENT T. MBBS +; LEVY, LORRAINE M. MBBS +; GWANZURA, CHRISTINE FIMLS *; MOYO, ALPHA FIMLS *; MUDENGE, BONIFACE FIMLS; KIIRE, CLEMENT MBBS +; MUKIIBI, JOSHUA MBBS *; STABLER, SALLY P. MD ++; LINDENBAUM, JOHN MD Abstract: Background: There has been little systematic study of the clinical spectrum of pancytopenia, and the optimal diagnostic approach to pancytopenia remains undefined. Methods: The authors studied 134 hospitalized pancytopenic patients in Zimbabwe in both consecutive and nonconsecutive fashion. Results: The most common cause of pancytopenia was megaloblastic anemia, followed by aplastic anemia, acute leukemia, acquired immunodeficiency syndrome (AIDS), and hypersplenism. Severe pancytopenia was usually due to aplastic anemia. Patients with aplastic anemia and acute leukemia were usually children, whereas those with megaloblastic anemia were adults. Moderate to severe anemia was noted throughout the series, but was most striking in patients with megaloblastic anemia, aplastic anemia, and acute leukemia. The mean corpuscular volume (MCV) was elevated in most patients with megaloblastic hematopoiesis, aplastic anemia, and acute nonlymphocytic leukemia. Normal or low MCV values were noted in almost one third of patients with megaloblastic anemia. Anisocytosis, poikilocytosis, macroovalocytosis, microcytosis, fragmentation, and teardrop erythrocytes were more prominent on the blood films of patients with megaloblastic anemia.

93. New Treadwell Library Page Iron deficiency anemia. Anemia of chronic disease (ACD). megaloblastic anemia (caused by deficiencies in the B vitamins folate, vitamin B12, or both). http://www.massgeneral.org/library/wc.asp?tm=n&page=000057.htm

94. Bleeding Infant - Megaloblastic Anemia - PediaIndia.net Pediaindia.net is a free, indian, pediatrics ediscussion forum which involve pediatricians with usual and difficult case discussions. http://pediaindia.net/archive/megaloblast.shtml

Archive Section Jan 16th - 31st 2001 Bleeding Infant - Megaloblastic Anemia (Please wait for the content to download) How did discussion proceed Query Asked A five-month-old male child presented with spontaneous bleeding from posterior of the neck. Child was full term normal vaginal delivery at home by Dai to a primigravida mother and mother did not attend any antenatal check up. On examination patient is malnourished, pale, show few petechial, ecchymotic rash over face and extremities. CVS and Respiratory system are normal. Per abdo liver is 3.5 cm and spleen is not palpable. Updates (Based on Responses) Baseline hematological parameters received are Hb of 8.4 g%, TLC of 4,400, ESR of 28 mm, Platelet count of 16,000, N L E M . Child was taking feeds normally during this period. There is no history of loose motions in the recent past. Child is not icteric but his serum bilirubin is 2.1 gm%. There is no history of jaundice in the child. No history of bleeding from any site due to i/m injection before this. PT (at admission) of the child is Test - 13.4 sec, Control - 13.6 sec. PTTK (at admission) of the child is Test - 28.3 sec, Control - 24.8 sec. There is no history suggestive of obvious skin lesion like hemangioma. Blood culture and CRP of child received are negative. White string is drain, lesion got the secondary infection. Complete hemogram report from automated counter is Hb - 8.6 g%, TLC 4,100, Total RBC count 2.38 x 10

95. Megaloblastic Anemia megaloblastic anemia view of red blood cells megaloblastic anemia is a blood disorder characterized by anemia, with red blood cells that are larger http://www.shands.org/health/information/article/000567.htm

Disease Injury Nutrition Poison ... Blood cells Megaloblastic anemia Definition: Megaloblastic anemia is a blood disorder characterized by anemia, with red blood cells that are larger than normal, usually resulting from a deficiency of folic acid or of vitamin B-12 Alternative Names: Anemia - megaloblastic Causes, incidence, and risk factors: Deficiencies of vitamin B-12 and folic acid are the most common causes of megaloblastic anemia. Other causes are leukemia, myelofibrosis multiple myeloma , certain hereditary disorders, drugs that affect DNA synthesis such as chemotherapy agents (methotrexate), alcohol, and other causes. Risk factors relate to the causes. (See also pernicious anemia Symptoms: Loss of appetite Diarrhea Tingling and numbness of hands and feet Pale skin color Tiredness Headaches Sore mouth and tongue Change in skin color Signs and tests: Examination of neurological signs may show abnormal reflexes, decreased position sense, and decreased vibration sense if related to vitamin B-12 deficiency. Tests include: Complete blood count (shows anemia with large red blood cells) Bone marrow examination Serum B-12 Schilling test (may identify poor absorption as cause of vitamin B-12 deficiency) Serum folate Treatment: The objective of treatment is to determine the cause of the anemia, and the treatment depends upon the cause. Anemias related to vitamin deficiencies are discussed separately.

96. The Body: Women And Anemia megaloblastic anemia means that your red blood cells are large and pale. Often times the first signs of megaloblastic anemia is when the mean cell volume is http://www.thebody.com/wa/spring99/anemia.html

@import url(/css/thebody.css); @import url(/css/article.css); var zflag_nid="362"; var zflag_cid="1"; var zflag_sid="0"; var zflag_width="728"; var zflag_height="102"; var zflag_sz="26"; Just Diagnosed HIV Treatment Living With HIV HIV Around the World ... Conference Coverage Women Alive Women and Anemia By Debra Johnson, NP, PA-C and Judith Currier, MD Spring 1999 Anemia can be a very common finding in HIV-infection. There may be many causes; low red blood counts, low vitamin B12 stores, iron deficiency, a thyroid that may not be functioning correctly, a lot of blood loss during menses, low hormone levels, an effect from medication or an infection that invades the bone marrow (parvo B19, MAC, or a deep fungal infection). Risk Factor As many as 70-80% of HIV-infected patients develop anemia at some time during the course of their infection. Several clinical studies have suggested that anemia is an independent risk for a decrease in survival in patients with HIV disease. It is not clear if anemia was the only cause of a decrease in survival or if it is a part of concomitant opportunistic illness such as Mycobacterium avium or cytomegalovirus disease. One study done at Johns Hopkins University School of Medicine found anemia to be a rather strong risk factor for dying in patients infected with HIV. Many times women become so accustomed to feeling fatigue that they may never report it when they see their clinician. Sometimes anemia is such a common finding, that clinicians may not realize the impact that it can have on a women's energy level.

97. Megaloblastic Anemia megaloblastic anemia . A form of anemia that is characterized by abnormally large red blood cells. It is usually caused by folic acid and/or vitamin B12 http://www.sparknotes.com/health/assessment/biochemical/terms/term_18.html

Megaloblastic anemia - A form of anemia that is characterized by abnormally large red blood cells. It is usually caused by folic acid and/or vitamin B12 deficiency.

98. Best Practice Medicine- Professional Reference - Anemia Wrong diagnosis megaloblastic anemia not caused by folate or vitamin B12 deficiency;; Noncompliance;; Combined folate and vitamin B12 deficiency being http://merck.micromedex.com/index.asp?page=bpm_brief&article_id=BPM01HE01

99. Megaloblastic (Pernicious) Anemia -Blood Diseases & Disorders A definition of pernicious anemia, the causes, symptoms, diagnosis and treatment are discussed. http://www.umm.edu/blood/aneper.htm

var MenuLinkedBy='AllWebMenus [2]', awmBN='530'; awmAltUrl=''; Donations / Banking Blood Diseases Blood Disorders... Anemias... ... Site Map Related Resources Within UMM Hematology Pediatric Oncology Translate using Google to Spanish German French Italian Portuguese Blood Diseases Megaloblastic (Pernicious) Anemia What is megaloblastic (pernicious) anemia? Megaloblastic (pernicious) anemia is a rare disorder in which the body does not absorb enough vitamin B12 from the digestive tract, resulting in an inadequate amount of red blood cells (RBCs) produced. What causes megaloblastic (pernicious) anemia? Megaloblastic (pernicious) anemia is more common in individuals of northern European descent. Megaloblastic (pernicious) anemia results from a lack of intrinsic factor in gastric secretions (a substance needed to absorb vitamin B12 from the gastrointestinal tract). Vitamin B12 deficiency results. The inability to make intrinsic factor may be the result of chronic gastritis, or the result of a gastrectomy (removal of all or part of the stomach). Megaloblastic (pernicious) anemia may also be associated with type 1 diabetes, thyroid disease, and a family history of the disease. What are the symptoms of megaloblastic (pernicious) anemia?

100. Megaloblastic (Pernicious) Anemia Detailed information on megaloblastic (pernicious) anemia, including causes, symptoms, diagnosis, and treatment. http://www.healthsystem.virginia.edu/uvahealth/peds_hematology/megalob.cfm

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