Megaloblastic anemia causes, like any anemic process, a decrease in red blood cells. The main cause, in most cases, is due to a deficiency of vitamin B12 and/or folic acid, essential vitamins for the maturation of red blood cells. It is important to prevent risk factors and diagnose it correctly for proper treatment.
Megaloblastic anemia: what is it?
Megaloblastic anemia, like any type of anemia, is a syndromic process that has its origin in a red blood cell maturation defect, so the immediate consequence is a decreased survival or accelerated destruction of red blood cells. It is so called because, morphologically, when we observe the red blood cells under the light microscope, they have a large size.
Causes or origins of megaloblastic anemia
The most common cause of megaloblastic anemia, which occurs in 90% of cases, is a deficiency of vitamin B12 and/or folic acid. These two vitamins are necessary for the correct differentiation and maturation of young red blood cells. It has a prevalence of approximately 1/10,000 inhabitants and years, with a prevalence of 10% in the population. A peculiar case of deficiency of vitamin B12 absorption during fasting produces an anemia of this type known as Pernicious Anemia.
Other less frequent causes that can originate it are:
– Alcoholism
– Certain hereditary disorders
– Medications that affect cellular DNA, such as chemotherapeutics.
– Other intrinsic hematological diseases
Megaloblastic Anemia: Signs and Symptoms
As in any anemic syndrome, the main symptom is fatigue. Other patients report headache, blurred vision, diarrhea or constipation, poor appetite, problems concentrating or difficulty breathing, among others.
The cardinal sign remains skin pallor, although some patients may acquire a yellowish or jaundiced tinge. The tongue usually acquires a geographic appearance due to atrophy of the taste buds, which is called saburral tongue.
In the most extreme cases of this anemia, neurological signs due to cognitive impairment have been described. This has been described in extreme deficiencies of vitamin B12, not folic acid, since this vitamin is also involved in the maturation of the cells of the nervous system and in the formation of their myelin sheaths. These symptoms include depression, altered balance, numbness and tingling of hands and feet, and even confusion that can lead to dementia.
Can megaloblastic anemia be prevented?
Hematology experts recommend:
– consume foods containing vitamin B12, such as beef, poultry, seafood, eggs and dairy products.
– avoid consumption of antacids for a continuous and prolonged period of over 3 months.
– avoidance of chronic alcoholism, among others.
Diagnosis of megaloblastic anemia and underlying disease
As in any type of anemia, the physician should carry out an exhaustive clinical history of the patient to try to identify possible causes of either a lack of consumption of foods rich in vitamin B12 (such as strict vegetarian diets) or difficulty in the absorption of the vitamin, as in the case of certain types of inflammatory intestinal diseases (Crohn’s disease, ulcerative colitis) or chronic gastritis, among other pathologies.
Depending on the data collected from the patient’s clinical history, as well as a structured physical examination, the pertinent analytical and imaging tests or consultation with other relevant specialists will be referred in order to find the origin of the disease.
Treatment and prognosis of megaloblastic anemia
The treatment of megaloblastic anemia involves vitamin supplementation in those cases of deficiency, or the treatment of the underlying pathology in case the causative clinical entity is diagnosed. Everything will depend on the results of the complementary tests performed.
The prognosis is, in general, very good, as long as it is diagnosed in time and the possible underlying cause is investigated. For this reason it is of vital importance that the patient goes to his or her general practitioner in the event of any sign or symptom compatible with an anemic process.