Vitamin B[12] deficiency- a major cause of megaloblastic anaemia in patients attending a tertiary care hospital

ABSTRACT

Folate and vitamin B[12] deficiencies have been known to cause megaloblastic anaemia. Since the deficiencies of these two vitamins are very common in Pakistani population, it would be imperative to investigate their role in causing megaloblastic anaemia. The objective of this study was to find out the contribution of folate and vitamin B[12] deficiencies in causing megalobalstic anaemia in our patient population. In this retrospective cohort study, clinical records of 220 patients [101 females and 119 males with an age range of 1-80 years] who presented themselves with macrocytic anaemia at the Aga Khan University Hospital were collected. Data pertaining to complete blood count and serum levels of folate and vitamin B[12] were analysed. The mean haemoglobin [Hb] level was 6.8 +/- 0.2 gm/dl. Sixty-nine percent of the patients had severe anaemia [Hb<8gm/ dl]. Mean +/- SEM values of haemoglobin, serum folate and serum B[12] were not significantly different between males and females [Hb 6.4 +/- 0.3 gm/dl vs 6.3 +/- 0.3 gm/dl; folate 6.9 +/- 0.8 eta g/ml vs 7.8 +/- 1 eta g/ml; B[12] 259 +/- 65 rho g/ml vs 225 +/- 45 rho g/ml, respectively]. Linear regression analysis showed that serum folate was inversely related with the mean corpuscular volume [MCV, p=0.04]. Spearman's correlation analysis indicated an inverse mild association between MCV and serum folate [correlation coefficient= -0.18]. Folate deficiency was 43.3%, while vitamin B[12] deficiency was 78.5% in these patients. Seventy-one percent of folate-deficient patients had vitamin B[12] deficiency was 78.5% in these patients. Seventy-one percent of folate-deficient patients had vitamin B[12] deficiency as well, while 26.1% of patients with B[12] deficiency had a co-occurrence of folate deficiency. Vitamin B[12] deficiency appears to be the major factor leading to megaloblastic anaemia in our study population. Inadequate dietary intake, over-cooking of our food and poor absorption might be contributing to high prevalence of vitamin B[12] deficiency in this population