Serum B[12] and folate levels in patients with megaloblastic change in the bone marrow

ABSTRACT

Vitamin B12 and folic acid are essential components of DNA synthesis in red cell precursors. Folic acid is directly involved and Vitamin B12 [methyl cobalamine] participates as a cofactor. A deficiency of Vitamin B12 causes the same symptoms as folic acid deficiency. The study was carried out to find the cause of megaloblastic anemia. In this descriptive study, we evaluated clinical and morphological features of 80 consecutive patients with a megaloblastic change in bone marrow from 2008-2010. The study was carried out in the Hematology Laboratory, Services Institute of Medical Sciences, Lahore. Eighty patients with a megaloblastic change in bone marrow were studied. There were 32 males [40%] and 48 females [60%]. The most common clinical presentation was pallor and fatigue [67 patients, 84%]. Out of the 80 patients, 50 [62.5%] were deficient in folic acid and 24 patients [30%] were Vitamin B12 deficient. 6 patients [7.5%] were Coomb's positive, indicating Immunemediated Hemolytic Anemia as the cause of megaloblastic anemia. Folic acid deficiency was the most common cause of megaloblastic anemia [62.5%] in the given population. Vitamin B12 deficiency was the next most common cause [30%]. 6 patients [7.5%] had normal levels of Vitamin B12 and Folic acid and were Coomb's positive showing that Immune - mediated hemolytic anemia can also be a cause of megaloblastic change in the bone marrow