Flashcards in Macrocytic anaemia Deck (7)
what are the 2 types of macrocytic anaemia?
- Megaloblastic: bone marrow produced large, abnormal immature red cells
what are the megaloblastic causes?
- B12 def (dec absorption, dec intake, abnormal metabolism)
- Folate def (dec intake, inc demand, dec absorption, jejunal disease, drugs)
- Drugs (methotrexate, hydroxyurea, azathioprine)
what are the non-megaloblastic causes?
- alcohol excess
- liver disease
- multiple myeloma
- Haemolysis (HA)
what are the symptoms of macrocytic anameia?
- anaemia symptoms (tiredness, lethargy, dyspnoea)
- FHx of AI disease
- PMHx GI surgery
what are the signs of macrocytic anaemia?
- anaemia: pallor, tachycardia, dyspnoea
- Pernicious anaemia: jaundice, glossitis, angular stomatitis, weight loss
- B12 def: peripheral neuropathy, ataxia, sub-acute combined degeneration of cord, optic atrophy, dementia
what investigations would you do?
- FBC: high MCV, pancytopenia
- B12 levels
- red cell folate
- LFTs (high BR)
- anti-parietal cells/ anti-IF antibodies
- Blood film: hypersegmented-nuclei neutrophils
- Schilling test - Pernicious anaemia (B12 only absorbed when given IF)