Megaloblastic anemia for Lab.students

1. Megaloblastic anemia
Developed by-Dr.Abdulrazzaq Othman Alagbare
M.D M.S.c C.P - Lecturer of Hematology and Immunohematology
1
6/8/2020

2. Pernicious
anemia
Non
Megaloblastic
anemia
Megaloblastic
anemia
What is a Megaloblastic Anemia? Anemias in which the RBCs are oval
macrocytes, with an MCV larger than normal (>115-150 fL).
Types of megaloblastic anemia Causes
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3. Causes of B12 and folic acid deficiency
 Lack intake foods rich with vitamin B12 or folic acid
 Increase of demands (Growth. Pregnancy.
Chemotherapy etc)
Insufficient intake
Post infectious diseases or parasitic infection.Absorption defect
Atrophic gastritis (elderly) no production, or • Post
gastrectomy • autoimmune
Intrinsic factor
defect
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4. Symptoms of Megaloblastic Anemia
1.Symptoms of anemia
2.Neurological symptoms
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5. CBC result in megaloblastic anemia
Pancytopenia  in sever cases Low of all types of cells in the peripheral blood
RBC: WBC: Platelets
1-Hb; low
2-MCV over 94 up to 120
fl
3-MCH  low
4-Retic-Count Low
Blood smear:
oval macrocytic RBC
Count : Low count
Blood smear: -
Presence of polysegmented
neutrophils with over 5 lobes
low count
Giant PLT
Reticulocyte count: inadequate for the degree of anemia
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6. Pernicious anemia (PA)
 is a type of megaloblastic
anemia age of patient often >
60 years old
 Same symptoms and Lab.
Finding with Megaloblastic
anemia
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7. Pernicious anemia (PA) … Caused by…
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70 % it is an autoimmune disease30% caused by gastritis or
gastroectomy etc.
auto-antibodies produced against
gastric parietal cells or against the IF
protein , leading to No intrinsic factor
secretion

8. Case The main diagnostic test
Megaloblastic anemia B12-
Deficiency
Decrease Serum level of B12
Megaloblastic anemia –Folic
acid Deficiency
Decrease Serum and red cell folate
level
Pernicious anemia Decrease Serum level of B12 and
Folic acid
70%  antibodies in there serum
for…
o Detecting anti partial antibodies
o Detecting anti IF antibodies
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9. 1-form of macrocytic anemia
2-its has no the typical laboratory finding
of megaloblastic anemia
3-No related to folic acid deficiency
(especially alcoholism)
5-The MCV is between 108-110 fl
Causes of :
1-Liver diseases
2-Alcholism
Normally physiologic macrocytosis in
1. Pregnancy
2. New born
NON MEGALOBLASTIC MACROCYTIC ANEMIA (Macrocytosis)
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10. Non Megaloblastic anemia – Liver Diseases
The PBS show
 Round macrocytes RBC
that are usually seen in
alcoholism and obstructive liver
disease.
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11.  Macrocytes in true megaloblastic
conditions are oval
macrocytes
 as opposed to the round macrocytes that
are usually seen in alcoholism and
obstructive liver disease.
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12. Anemia of Chronic Liver Disease
The patient has sever liver disease
Risk factors
1- alcoholism
2- folate deficiency
All that develop anemia characterized as
 Short RBC lived
 Low EPO production
PBS
• Normochromic normocytic ia anem
• Some cases are
macrocytic(MCV>100).
• Mostly rounded Target cells
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‫رب‬ ‫هلل‬ ‫الحمد‬
‫العالمين‬
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‫هللا‬