1. MEGALOBLASTIC ANEMIAS An article by Thomas G. DeLoughery, Associate Professor of Medicine discussing all aspects of this disorder.Category Health Conditions and Diseases Anemia Megaloblastic...... The LDH level is often in the 1,000's in patients with megaloblastic anemia. THERAPY.Patients with severe megaloblastic anemia need immediate therapy. http://www.ohsu.edu/som-hemonc/handouts/deloughery/megalobl.shtml

3181 SW Sam Jackson Park Road, OP28 Portland, OR 97201 fax Home Welcome News Adult Bone Marrow Transplantation ... PRINT VERSION Thomas G. DeLoughery Associate Professor of Medicine March 15, 1999 MEGALOBLASTIC ANEMIAS MACROCYTOSIS An increased MCV can be due to a number of reasons but careful review of the patient's history and blood smear can narrow the diagnostic possibilities. The differential can be divided into two broad categories based on RBC morphology. Round macrocytosis-due to abnormal lipid composition of the erythrocyte membrane. Common etiologies include: Alcoholism. Liver Disease. Renal Disease. Hypothyroidism ("myxedema of the red cell"). Oval macrocytosis (macroovalocytes) is a sign of problem with cell DNA replication. The developing red cell has difficulty in undergoing cell division but RNA continues to be translated and transcribed into protein leading to growth of the cytoplasm while the nucleus lags behind. Often one or more cell division are skipped leading to a larger than normal cell. Common causes are: Drug effect including cytotoxic chemotherapy (AZT now most common etiology of increased MCV).

2. MEDLINEplus Medical Encyclopedia: Megaloblastic Anemia megaloblastic anemia is a blood disorder characterized by anemia, with red blood cells that are larger than normal, http://www.nlm.nih.gov/medlineplus/ency/article/000567.htm

Skip navigation Medical Encyclopedia Other encyclopedia topics: A-Ag Ah-Ap Aq-Az B-Bk ... Z Megaloblastic anemia Contents of this page: Illustrations Alternative names Definition Causes, incidence, and risk factors ... Prevention Illustrations Megaloblastic anemia - view of red blood cells Hypersegmented PMN (Close-up) Blood cells Alternative names Return to top Anemia - megaloblastic Definition Return to top 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 Vitamin B-12 Causes, incidence, and risk factors Return to top 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 Return to top 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 Return to top Examination of neurological signs may show abnormal reflexes, decreased position sense, and decreased vibration sense if related to Vitamin B12 deficiency.

3. Megaloblastic Anaemia Haematological profile, diagnosis and treatment of megaloblastic anemia. Vitamin B12 deficiency and frolic acid deficiency. http://www.uq.edu.au/vdu/HDUAnaemiaMegaloblastic.htm

Human Metapneumovirus Links Megaloblastic Anaemia Diagnosis Many cases are seen that have a decreased serum B12 with a normal haematological profile and possibly normal clinical findings Test for methylmalonic acid in the serum as an indicator of vitB12 deficiency Test for homocysteine to check folate levels Haematological Profile Hb/RCC/Hct - Dec (due to Dec. DNA production) MCV/MCH - Inc. (As precursors are megaloblastic) MCHC - Normal RDW - Inc. (Anisocytosis due to microcytes, normocytes and oval macrocytes) Plt./WCC - Dec Pancytopaenia with a normochromic, macrocytic anaemia Intramedullary haemolysis due to ineffective erythropoiesis (reason for hypercellular BM) Poikilocytosis - ++ (tear drops and schistocytes) Anisocytosis - +++ (oval macrocytes) A "Shift-to-the-Left" indicates an Inc. in band form WBCs Hypercellular bone marrow (M:E at 1:1 or reversed) Erythron Large cells with fine chromatin (Megaloblasts) Nuclear(N)/Cytoplasmic(C) dissociation with N lagging C - normal cytoplasmic maturation Multiple Howell-Jolly bodies (diagnostic if observed) Leucon Giant myelocytes and metamyelocytes Thrombon Often not obvious The peripheral blood (PB) and bone marrow (BM) findings do not distinguish between a vitamin B12/cobalamin deficiency and a folic acid (folate) deficiency

4. Anemia, Macrocytic CBC with megaloblastic anemia, diagram U. of Utah Webpath; Hypersegmented neutrophilwith megaloblastic anemia on smear, microscopic U. of Utah Webpath; http://www.ohsu.edu/cliniweb/C15/C15.378.71.252.html

Anemia, Macrocytic Back to previous level Anemia, Megaloblastic [1 more specific term/s, 1 more link/s] Search PUBMED for Anemia, Megaloblastic: All Review Therapy Diagnosis ... Megaloblastic Anemia: Oregon Health Sciences U.

5. Genetic Mutations Linked To Rare Metabolic Disease Columbus, Ohio Researchers have identified two mutations in a single gene as the cause of a rare disease, megaloblastic anemia. http://www.osu.edu/units/research/archive/cubn.htm

OSU Research News Service (physical and natural sciences) OSU Newsfeatures Service (social and behavioral sciences) OSU Cancer Report (cancer research and treatment) OSU News Research Archive (an archive of past stories) Coverage of OSU Research Reports on national news stories Frontiers (a magazine about cancer research and treatment) Synergy (a magazine produced by the College of Biological Sciences) Reporting on Cancer (a reporter's guide to the disease) Ralf Krahe GENETIC MUTATIONS LINKED TO RARE METABOLIC DISEASE COLUMBUS, Ohio Researchers have identified two mutations in a single gene as the cause of a very rare metabolic disease that affects people in Finland, Norway and Saudi Arabia. It has taken nearly 40 years since the identification of the disease for researchers to trace its cause back to a faulty gene. An international team of a dozen scientists, including those from Ohio State University, reported their discovery in the latest issue of the journal Nature Genetics Called megaloblastic anemia 1, or Imerslund-Grasbeck syndrome after the two researchers who first described it, the defects prevent the normal absorption of vitamin B-12. If left untreated, the disease can be fatal. While serious, the syndrome is exceedingly rare only one person in a million may develop this disease. The disease has also been identified in patients from Israel, Turkey, Kuwait and the United States as well.

6. LabCorp Megaloblastic Anemia will exacerbate the development of folate defi. ciency. megaloblastic anemia in alcoholics is most always due to fo- http://www.labcorp.com/cme/CME_Megaloblastic_Anemia_Journal_Article_0608.pdf

7. MEDLINEplus Medical Encyclopedia: Megaloblastic Anemia - View Of Red Blood Cells megaloblastic anemia view of red blood cells. This picture shows large, dense,oversized, red blood cells (RBCs) that are seen in megaloblastic anemia. http://www.nlm.nih.gov/medlineplus/ency/imagepages/1214.htm

Skip navigation Medical Encyclopedia Megaloblastic anemia - view of red blood cells This picture shows large, dense, oversized, red blood cells (RBCs) that are seen in megaloblastic anemia. Megaloblastic anemia can occur when there is a deficiency of vitamin B-12. Health Topics Drug Information Encyclopedia Dictionary ... National Institutes of Health Page last updated: 10 January 2003

8. RCD - MEGALOBLASTIC ANEMIA megaloblastic anemia The normal proliferation of cells depends on adequate folate and vitamin B12. Folate is necessary for efficient thymidilate synthesis and production of DNA. B12 is needed to successfully incorporate circulating folic acid into http://www.med.virginia.edu/medicine/clinical/pathology/educ/innes/text/rcd/mega

Megaloblastic Anemia The normal proliferation of cells depends on adequate folate and vitamin B12. Folate is necessary for efficient thymidilate synthesis and production of DNA. is needed to successfully incorporate circulating folic acid into developing RBCs; retaining the folate in the RBC. Review the metabolic mechanisms of B12 and folate (See Normal Hematopoiesis-B12 and Folate Metabolism) Pyrimidines: thymine, cytosine, and uracil Purines: adenine and guanine Lack of folate or B12 leads to decreased dTTP synthesis, resulting in a slowing of DNA synthesis. The role of folate is illustrated at right. The mechanism by which B12 leads to decreased DNA synthesis is unclear. Two likely explanations follow. Methylfolate "trap" hypothesis . Lack of cobalamin slows the methyltransferase reaction resulting in increased N5-methyl FH4. Thus N5-methyl FH4 is "trapped" or unable to be metabolized to FH4. N5-methyl FH4 can convert to N5, 10-methylene FH4, but poorly without new FH4 other forms of folate diminish leading to slowed synthesis of dTMP. Formate "starvation" hypothesis . Lack of cobalamine slows the methyltransferase reaction deceasing methionine production and in turn depressing formate generation. A deficiency of either vitamin Bl2 or folic acid results in megaloblastic erythroid cells-

9. Megaloblastic Anemia megaloblastic anemia. Causes, incidence, and risk factors Deficiencies of VitaminB12 and folic acid are the most common causes of megaloblastic anemia. http://www.umm.edu/ency/article/000567.htm

Disease Nutrition Surgery Symptoms Injury ... Z Related Programs at UM Medical Center Department of Orthopaedics Home Medical Reference Encyclopedia (English) Toggle English Spanish Megaloblastic anemia Overview Symptoms Treatment Prevention 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 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 Megaloblastic anemia - view of red blood cells Hypersegmented PMN (Close-up) Blood cells Review Date: 10/8/2001 Reviewed By: Rebecca Elstrom, M.D., University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Home Health Info Our Physicians Our Services ... Make Appt.

10. Hematopathology CBC here shows a markedly increased MCV, typical for megaloblastic anemia. The MCV can be mildly increased in persons http://www-medlib.med.utah.edu/WebPath/HEMEHTML/HEME025.html

The CBC here shows a markedly increased MCV, typical for megaloblastic anemia. The MCV can be mildly increased in persons recovering from blood loss or hemolytic anemia, because the newly released RBC's, the reticulocytes, are increased in size over normal RBC's, which decrease in size slightly with aging.

11. EMedicine - Megaloblastic Anemia : Article By Paul Schick, MD megaloblastic anemia megaloblastic anemias are a heterogeneous group of disordersthat share common morphologic characteristics. megaloblastic anemia. http://www.emedicine.com/MED/topic1420.htm

(advertisement) Home Specialties CME PDA ... Patient Education Articles Images CME Patient Education Advanced Search Link to this site Back to: eMedicine Specialties Medicine, Ob/Gyn, Psychiatry, and Surgery Hematology Megaloblastic Anemia Last Updated: November 14, 2002 Rate this Article Email to a Colleague Synonyms and related keywords: blood disorder, megaloblastosis, cobalamin deficiency, vitamin B-12 deficiency, folate deficiency, pernicious anemia, PA, cobalamin neuropathy, ineffective erythropoiesis, food-cobalamin malabsorption, gastrectomy, Zollinger-Ellison syndrome, ZES, ileal resection, regional ileitis, intestinal lymphoma, Diphyllobothrium latum, D latum, fish tapeworm, blind loop syndrome, nitrous oxide exposure, NO exposure, surgical intestinal resection, amyloidosis, Whipple disease, scleroderma, psoriasis, exfoliative dermatitis, pregnancy, drug reactions, chemotherapy AUTHOR INFORMATION Section 1 of 10 Author Information Introduction Clinical Differentials ... Bibliography Author: Paul Schick, MD

12. EMedicine - Anemia, Megaloblastic : Article By James L Harper, MD Anemia, Megaloblastic megaloblastic anemia is an uncommon problem in childhoodmost frequently associated with vitamin deficiency or gastrointestinal disease http://www.emedicine.com/ped/topic2575.htm

(advertisement) Home Specialties CME PDA ... Patient Education Articles Images CME Patient Education Advanced Search Link to this site Back to: eMedicine Specialties Pediatrics Hematology Anemia, Megaloblastic Last Updated: March 1, 2002 Rate this Article Email to a Colleague AUTHOR INFORMATION Section 1 of 10 Author Information Introduction Clinical Differentials ... Bibliography Author: James L Harper, MD , Director of Nebraska Regional Hemophilia Treatment Center, Associate Professor, Department of Pediatrics, University of Nebraska Medical Center James L Harper, MD, is a member of the following medical societies: American Academy of Pediatrics American Medical Association American Society of Hematology , and Nebraska Medical Association Editor(s): Sharada A Sarnaik, MD , Director of Sickle Cell Program, Professor, Department of Pediatrics, Children's Hospital of Michigan and Wayne State University; Robert Konop, PharmD , Clinical Assistant Professor, Department of Pharmacy, Section of Clinical Pharmacology, University of Minnesota; Steven K Bergstrom, MD

13. Megaloblastic Anemia (vitamin B12 Deficiency) next up previous Next Case 1 Up Atlas of Hematology Previous Irondeficiency anemia. megaloblastic anemia (vitamin B12 deficiency). http://pathy.med.nagoya-u.ac.jp/atlas/doc/node106.html

14. 1Up Health > Megaloblastic Anemia > Causes, Incidence, And Risk Factors Of Megal Comprehesive information on megaloblastic anemia (Anemia megaloblastic). Megaloblasticanemia Causes, Incidence, and Risk Factors. Alternative names http://www.1uphealth.com/health/megaloblastic_anemia_info.html

1Up Health Megaloblastic anemia Alternative Medicine Clinical Trials ... Health Topics A-Z Search 1Up Health Megaloblastic anemia Information Megaloblastic anemia Causes, Incidence, and Risk Factors Alternative names : Anemia - megaloblastic 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 Vitamin B-12 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 Previous Next Jump to Another Section of this Guide Definition Causes, Incidence, and Risk Factors Symptoms Prevention Diagnosis, Signs, and Tests Treatment ... Calling your Health Care Provider Related Tools and Utilities Search Books on Amazon: Read Articles on eLibrary: Health Products on drugstore.com:

15. 1Up Health > Megaloblastic Anemia (Anemia - Megaloblastic) Information Comprehesive information on megaloblastic anemia (Anemia megaloblastic). 1UpHealth Diseases Conditions megaloblastic anemia. http://www.1uphealth.com/health/megaloblastic_anemia.html

1Up Health Alternative Medicine Clinical Trials Health News ... Health Topics A-Z Search 1Up Health Megaloblastic anemia Information Guide Alternative names : Anemia - megaloblastic 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 Vitamin B-12 Jump to a Section of this Guide Definition Causes, Incidence, and Risk Factors Symptoms Prevention ... Calling your Health Care Provider Related Tools and Utilities Search Books on Amazon: Read Articles on eLibrary: Health Products on drugstore.com: Anemia Folate deficiency Leukemia Multiple myeloma ... More More Topics Appetite - decreased Chemotherapy Diarrhea Fatigue ... More Search 1Up Health A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is the first of its kind, requiring compliance with 53 standards of quality and accountability, verified by independent audit. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial reviewers . A.D.A.M. is also a founding member of Hi-Ethics (www.hiethics.com) and subscribes to the principles of the Health on the Net Foundation (www.hon.ch). Home Contact Us Privacy Links Directory

16. Health Ency.: Disease: Megaloblastic Anemia megaloblastic anemia See images. Causes and Risks. Deficiencies of VitaminB12 and folic acid are the most common causes of megaloblastic anemia. http://www.accessatlanta.com/shared/health/adam/ency/article/000567.html

SEARCH: The Web Yellow Pages HOME AJC.COM Illustrated Health Encyclopedia Important notice Ency. home Disease M Megaloblastic anemia See images Overview Symptoms Treatment ... Prevention Alternative names: Anemia - megaloblastic 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 Vitamin B-12 Causes and Risks 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 Ency. home Disease M Please read this Important notice Also Check Out Subscribe to The Atlanta Journal-Constitution Home Autos Classifieds ... Our Sponsors By using AccessAtlanta.com you accept the terms of our Visitor Agreement . Please read it. Privacy statement Registered site users: edit your profile

17. Health Ency.: Disease: Megaloblastic Anemia megaloblastic anemia See images. Alternative names Anemia megaloblastic.Treatment. The objective of treatment is to determine the http://www.accessatlanta.com/shared/health/adam/ency/article/000567trt.html

SEARCH: The Web Yellow Pages HOME AJC.COM Illustrated Health Encyclopedia Important notice Ency. home Disease M Megaloblastic anemia See images Overview Symptoms Treatment ... Prevention Alternative names: Anemia - megaloblastic 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. Prognosis The outcome is expected to be good with treatment. Complications Complications vary with the underlying cause. Call Your Health Care Provider If: Call for an appointment with your health care provider if symptoms develop. Ency. home Disease M Please read this Important notice Also Check Out Subscribe to The Atlanta Journal-Constitution Home Autos Classifieds ... Our Sponsors By using AccessAtlanta.com you accept the terms of our Visitor Agreement . Please read it. Privacy statement Registered site users: edit your profile

18. ThirdAge - Adam - Megaloblastic Anemia megaloblastic anemia. Definition Deficiencies of Vitamin B12 andfolic acid are the most common causes of megaloblastic anemia. http://www.thirdage.com/health/adam/ency/article/000567.htm

document.write(''); document.write(''); document.write('<'); document.write('/SCRIPT>'); document.write(''); document.write(''); document.write('<'); document.write('/A>'); document.write('<'); document.write('/NOSCRIPT>'); document.write('<'); document.write('/IFRAME>'); Activities Computers Family Tree Health ... Prevention 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 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 Megaloblastic anemia - view of red blood cells Hypersegmented PMN (Close-up) Blood cells Review Date: 10/8/2001 Reviewed By: Rebecca Elstrom, M.D., University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network.

19. ThirdAge - Adam - Megaloblastic Anemia - View Of Red Blood Cells back. This picture shows large, dense, oversized, red blood cells(RBCs) that are seen in megaloblastic anemia. megaloblastic anemia http://www.thirdage.com/health/adam/imagepages/1214.htm

document.write(''); document.write(''); document.write('<'); document.write('/SCRIPT>'); document.write(''); document.write(''); document.write('<'); document.write('/A>'); document.write('<'); document.write('/NOSCRIPT>'); document.write('<'); document.write('/IFRAME>'); Activities Computers Family Tree Health ... Travel This picture shows large, dense, oversized, red blood cells (RBCs) that are seen in megaloblastic anemia. Megaloblastic anemia can occur when there is a deficiency of vitamin B-12. Review Date: 1/1/1997 Reviewed By: Mosby Publishing Company TOP CLICKS Memory Loss Smallpox Flu Shot Anthrax ... Depression document.write(''); document.write(''); document.write('<'); document.write('/SCRIPT>'); document.write(''); document.write(''); document.write('<'); document.write('/A>'); document.write('<'); document.write('/NOSCRIPT>'); document.write('<'); document.write('/IFRAME>'); THIS WEEK'S FEATURES Make every day like a spa visit Get your over-eating in control with this weight loss menu 5 smart bone-builders that can combat osteoporosis FREE NEWSLETTER Health See latest More Newsletters 2 Years FREE! That's DOUBLE Our Best Offer Ever!

20. Megaloblastic Anemia Return to Hematopathology Laboratory Overview PreviousSlide Next Slide megaloblastic anemia. http://www.som.tulane.edu/classware/pathology/medical_pathology/New_for_98/Hemat

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