Clinical Features Of Patients With Megaloblastic Anemia

Megaloblastic anemia is usually a disease of middle-aged to older age with a high predilection for women. Severe anemia, in which the hemoglobin drops to 7 to 8 g/dL, is accompanied by symptoms of anemias such as shortness of breath, light-headedness, extreme weakness, and pallor. Patients may experience glossitis (sore or enlarged tongue), dyspepsia, or diarrhea. Evidence of neurological involvement may be seen with patients experiencing numbness, vibratory loss (paresthesias), difficulties in balance and walking, and personality changes. Vitamin B12 deficiency causes a demyeliniza-tion of the peripheral nerves, the spinal column, and the brain, which can cause many of the more severe neurological symptoms such as spasticity or paranoia. Jaundice may be seen, because the average red cell life span in megaloblastic anemia is 75 days, a little more than one half of the average red cell life span of 120 days. The bilirubin level is elevated, and the lactate dehydrogenase (LDH) level is high, signifying hemolysis.

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