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Clinico-Hematological Profile of Megaloblastic Anemia

Source: www.indianpediatrics.net
Topic: Megaloblastic anemia
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Sort Desciption: Megaloblastic Anemia is one of the important causes of anemias in children. It is not an infrequent entity in poor socioeconomic condition. This condition has protean manifestations in childhood, ...

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Megaloblastic Anemia is one of the important causes of anemias in children. It is not an infrequent entity in poor socioeconomic condition. This condition has protean manifestations in childhood, sometimes mimicking a hematological malignancy like leukemia. Diagnosing this disease assumes great clinical importance since it responds exceedingly well to treatment. The present study evaluates the varying clinicohematological manifestations in 29 patients diagnosed as megaloblastic anemia over a three year period.

Subject and Methods

Twenty nine children (age range 3 months to 12 years) diagnosed as megaloblastic anemia over a period of three year (March 1993 to March 1996) were prospectively studied. All anemic children admitted with or without bleeding manifestations had their peripheral blood smear examined. Complete hemogram including platelet count and mean corpuscular volume (MCV) were also carried out in each child using Coulter T860 particle counter. The platelet count obtained from Coulter counter was always confirmed by peripheral smear examination. Cases with macrocytic blood picture on smear examination were subjected to bone marrow examination to confirm the diagnosis of megaloblastic anemia. In three cases, bone biopsy was also performed since the initial marrow aspiration was either unsuccessful or was diluted with peripheral blood. Serum B and folic acid could be estimated by radioimmunoassay in 10 children. The diagnosis of megaloblastic anemia was established on the basis of megaloblastic bone marrow. Other criteria included: macrocytic blood picture with or without MCV values greater than 100 fl. Biochemically pure vitamin B deficiency and folic acid deficiency were diagnosed when serum levels were below 80 pg/ml and 3 ng/ml, respectively(1). Though having no bearing on the diagnosis, iron profile (serum iron, total iron binding capacity and percentage iron saturation) was determined by techniques recommended by International Committee for Standardization in Hematology in 22 children(2). Iron profile, was done as an additional investigation for further ruling out concomitant iron deficiency.

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