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Megaloblastic Anemia

Source: www.camlt.org
Topic: Megaloblastic anemia
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Sort Desciption: Megaloblastic anemias are a heterogeneous group of disorders that have common blood abnormalities and symptoms. The characteristic blood picture consists of large oval erythrocytes, hypersegmented neutrophils and ...

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Megaloblastic anemias are a heterogeneous group of disorders that have common blood abnormalities and symptoms. The characteristic blood picture consists of large oval erythrocytes, hypersegmented neutrophils and large abnormal platelets. Bone marrow RBC precursors show abnormally high nuclear to cytoplasmic ratio and abnormal megakaryocytes. Nuclear maturation is delayed while cytoplasmic development is normal.

The diseases associated with megaloblastosis are primarily pernicious anemia (associated with vitamin B12 deficiency) and folic acid deficiency. Although the number of megaloblastic anemia cases has decreased in recent years, the incidence remains between 0.25-0.5 cases per 1000 in older individuals.

HISTORY:
Paul Ehrlich in 1880 first used the term megaloblast to describe the abnormal cells in the bone marrow of a patient with pernicious anemia. He felt the very large basophilic RBC precursor was a cell type unique to the disease. We now know that this cell is a morphologically and functionally abnormal counterpart of the normal erythroid precursor cell.

Thomas Addison first described pernicious anemia, the best known of the megaloblastic anemias, in 1855. For a number of years the disease was known as Addisonian anemia. Anton Biermer in 1872 first used the term, pernicious anemia.

Treatment for pernicious anemia was instituted in 1926 when it was found that giving patients large amounts of liver reversed the disease process. The active liver principle, vitamin B12, was discovered in 1948 but it took 25 years to develop a synthetic vitamin B12.

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