FOLATE DEFICIENCY ANEMIA

Folate deficiency anemia:

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Folic acid is found in green vegetables and offal.

The absorption process of folate goes in the upper part of small intestine.

Anemia caused by folate deficiency could be the result of poor dietary intake of vegetables.

This kind of anemia commonly occurs with malabsorption or increased folic acid utilization.
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Physiological causes of folic acid deficiency:

Pregnancy.

Lactation.

Prematurity.

Pathological causes of folate deficiency:

Inflammatory diseases:

Ex. Tuberculosis – psoriasis – crohn disease…..

Malabsorption:

Tropical spure.

Celiac disease.

Drugs:

Trimthoprim.

Phenytoin.
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Other reason of folate deficiency:

Alcohol excess – anorexia – old ages – poverty.

SYMPTOMS:

All symptoms appear because of anemia.

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Laboratory investigation:

Serum folate is low.

Normal level:

< 3 - 15 >

Red cell folate is also low.

Normal level:

< 160 – 640 >

Note:

If there is no dietary poor intake of folic acid then should perform the jejuna biopsy investigation to look for small bowel disease.

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DIFFIRETIONAL DIAGNOSIS:

Macrocytosis with MCV on the film of peripheral blood occur with a normoblastic rather than a megaloblastic bone marrow.

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FLOIC ACID DIFICIENCY

TREATMENT:

By giving 5mg folic acid/day.

Treating underlying cause.

Folate prophylactic treatment:

In pregnancy and patients with chronic haemolysis.
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internal medicine.
Dr.zafer Maklad.
zafernm@yahoo.com