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__NOTOC__
__NOTOC__
{{Macrocytic anemia}}
{{Macrocytic anemia}}
{{CMG}}
{{CMG}}; {{AE}} {{ADS}}{{OK}}
==Overview==
==Overview==
The common causes of megaloblastic anemia are less dietray intake, autoimmune disorders like [[pernicious anemia]], [[alcoholism]], increased demands like in [[pregnancy]] and due to drugs.
==Causes==
==Causes==
Normal B12 absorption and action are dependent of 5 things: dietary intake, acid in the stomach, pancreatic secretions, secretion of IF by Gastric parietal cells, an ileum that can absorb the IF-B12 complex
:* Nutritional defects (folic acid or vitamin B12 which is mainly from animal sources; [[vegan]]s may require supplementation)
:* Chronic liver diseases
:* Alcoholism
:* Pregnancy
:* Decreased production of [[intrinsic factor]] (this disease entity is called [[pernicious anemia]])
:* Intestinal [[malabsorption]] (due to an enteritis, [[celiac disease]] or other causes).
:* Fish tapeworm infestation ([[Diphyllobothrium]] latum)
:* Failure to replicate [[chromosomes]] due to lack of [[thymidine]].
:* [[Lesch-Nyhan Syndrome]]
:* Cytotoxic drugs interfering with DNA synthesis
:* [[Gut flora|intestinal flora]] disruption due to antibiotic use
==Causes==
===Life-threatening Causes===
*Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated. There are no life-threatening causes of [[disease name]], however complications resulting from untreated [[disease name]] is common.
*Life-threatening causes of [symptom/manifestation] include [cause1], [cause2], and [cause3].
*[Cause] is a life-threatening cause of [disease].


===Common Causes===
===Common Causes===
Common causes of macrocytsic anemia may include: causes of megaloblastic anemia and non megaloblastic anemia:<ref name="pmid10875288">{{cite journal |vauthors=Savage DG, Ogundipe A, Allen RH, Stabler SP, Lindenbaum J |title=Etiology and diagnostic evaluation of macrocytosis |journal=Am. J. Med. Sci. |volume=319 |issue=6 |pages=343–52 |date=June 2000 |pmid=10875288 |doi= |url=}}</ref>
Common causes of macrocytic anemia may include: causes of megaloblastic anemia and non megaloblastic anemia:<ref name="pmid10875288">{{cite journal |vauthors=Savage DG, Ogundipe A, Allen RH, Stabler SP, Lindenbaum J |title=Etiology and diagnostic evaluation of macrocytosis |journal=Am. J. Med. Sci. |volume=319 |issue=6 |pages=343–52 |date=June 2000 |pmid=10875288 |doi= |url=}}</ref><ref name="pmid29264027">{{cite journal |vauthors=Nagao T, Hirokawa M |title=Diagnosis and treatment of macrocytic anemias in adults |journal=J Gen Fam Med |volume=18 |issue=5 |pages=200–204 |date=October 2017 |pmid=29264027 |pmc=5689413 |doi=10.1002/jgf2.31 |url=}}</ref><ref name="pmid108752882">{{cite journal |vauthors=Savage DG, Ogundipe A, Allen RH, Stabler SP, Lindenbaum J |title=Etiology and diagnostic evaluation of macrocytosis |journal=Am. J. Med. Sci. |volume=319 |issue=6 |pages=343–52 |date=June 2000 |pmid=10875288 |doi= |url=}}</ref>


==== Megaloblastic ====
==== Megaloblastic ====
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*# Ileal resection and bypass
*# Ileal resection and bypass
* Folate Deficiency:
* Folate Deficiency:
*# Deficient intake.
*# Deficient intake
*# [[Alcoholism]]
*# Increased needs: [[pregnancy]], [[infant]], rapid cellular proliferation, and [[cirrhosis]]
*# Increased needs: [[pregnancy]], [[infant]], rapid cellular proliferation, and [[cirrhosis]]
*# Malabsorption (congenital and drug-induced)
*# Malabsorption (congenital and drug-induced)
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** [[Pyrimethamine]]
** [[Pyrimethamine]]
** [[Secobarbital sodium]]
** [[Secobarbital sodium]]
** [[Trimethoprim]]
** [[Erythroleukemia]].
** [[Erythroleukemia]].
==== Non megaloblastic ====
* [[Myelodysplasia]]
* [[Chronic liver disease]]
* [[Reticulocytosis]]
* [[Hypothyroidism]]


===Less Common Causes===
===Less Common Causes===
Less common causes of macrocytsic anemia include:  
Less common causes of macrocytsic anemia include: <ref name="pmid9930566">{{cite journal |vauthors=Rosenblatt DS, Whitehead VM |title=Cobalamin and folate deficiency: acquired and hereditary disorders in children |journal=Semin. Hematol. |volume=36 |issue=1 |pages=19–34 |date=January 1999 |pmid=9930566 |doi= |url=}}</ref>
* Combined Dieficiency (Tropical Sprue): Vitamin B12 & Folate.
* Combined deficiency(vitamin B12 & folate) [[Tropical sprue]]
* Inherited [[DNA]] Synthesis Disorders: Deficient [[thiamine]] and factors (e.g. enzymes) responsible for folate metabolism.
* Inherited [[DNA]] Synthesis Disorders: Deficient [[thiamine]] and factors (e.g. enzymes) responsible for folate metabolism.
* [[Lesch-Nyhan Syndrome]]
* [[Lesch-Nyhan Syndrome]]
**
* [[Methylmalonic aciduria]]
* [[Orotic aciduria]]


===Genetic Causes===
===Genetic Causes===
* [[Lesch-Nyhan Syndrome]]
* [[Lesch-Nyhan Syndrome]]
* [[Orotic aciduria]]
**
**


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|- bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Drug Side Effect'''
| '''Drug Side Effect'''
| bgcolor="Beige" |[[Amobarbital sodium]], [[Cycloserine]], [[Cytarabine]], [[Ethotoin]], [[Folic acid]] antagonists ([[methotrexate]]), [[Pergolide]], [[Purine]] antagonists ([[6-mercaptopurine]]), [[Pyrimidine]] antagonists (cytosine arabinoside), [[Phenobarbital]], [[Pyrimethamine]], [[Secobarbital sodium]]
| bgcolor="Beige" |[[Amobarbital sodium]], [[Cycloserine]], [[Cytarabine]], [[Ethotoin]], [[Folic acid]] antagonists ([[methotrexate]]), [[Pergolide]], [[Purine]] antagonists ([[6-mercaptopurine]]), [[Pyrimidine]] antagonists (cytosine arabinoside), [[Phenobarbital]], [[Pyrimethamine]], [[Secobarbital sodium]], [[Trimethoprim]]
|-
|-
|- bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
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|- bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Endocrine'''
| '''Endocrine'''
| bgcolor="Beige" | No underlying causes
| bgcolor="Beige" | [[Hypothyroidism]]
|-
|-
|- bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
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|- bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Genetic'''
| '''Genetic'''
| bgcolor="Beige" |[[Lesch-Nyhan Syndrome]]
| bgcolor="Beige" |[[Lesch-Nyhan Syndrome]], [[Methylmalonic aciduria|Methylmalonic aciduria,]] [[Orotic aciduria]]
|-
|-
|- bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Hematologic'''
| '''Hematologic'''
| bgcolor="Beige" | No underlying causes
| bgcolor="Beige" | [[Myelodysplasia]], [[Pernicious anemia]], [[Reticulocytosis]]
|-
|-
|- bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
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|- bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Nutritional/Metabolic'''
| '''Nutritional/Metabolic'''
| bgcolor="Beige" | No underlying causes
| bgcolor="Beige" | [[Alcoholism]], [[Folate deficiency]],[[Orotic aciduria]],  [[Vitamin B12]] deficiency
|-
|-
|- bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
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List the causes of the disease in alphabetical order:
List the causes of the disease in alphabetical order:
<div style="-moz-column-count:3; column-count:3;">
<div style="-moz-column-count:3; column-count:3;">
* [[Achlorhydria]]
* [[Alcoholism]]
* [[Alcoholism]]
* [[Amobarbital sodium]]
* [[Amobarbital sodium]]
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* [[Cytarabine]]
* [[Cytarabine]]
* ''[[Diphyllobothrium latum]]''
* ''[[Diphyllobothrium latum]]''
* [[Diverticulosis]]
* [[Ethotoin]]
* [[Ethotoin]]
* [[Fistula]]
* [[Folate deficiency]]
* [[Folic acid]] antagonists ([[methotrexate]])
* [[Folic acid]] antagonists ([[methotrexate]])
* [[Hypothyroidism]]
* [[Lesch-Nyhan Syndrome]]
* [[Lesch-Nyhan Syndrome]]
* [[Methylmalonic aciduria]]
* [[Myelodysplasia]]
* [[Orotic aciduria]]
* [[Pergolide]]
* [[Pergolide]]
* [[Pernicious anemia]]
* [[Purine]] antagonists ([[6-mercaptopurine]])
* [[Purine]] antagonists ([[6-mercaptopurine]])
* [[Pyrimidine]] antagonists (cytosine arabinoside)
* [[Pyrimidine]] antagonists (cytosine arabinoside)
* [[Phenobarbital]]
* [[Phenobarbital]]
* [[Pyrimethamine]],
* [[Pregnancy]]
* [[Pyrimethamine]]  
* [[Reticulocytosis]]
* [[Secobarbital sodium]]  
* [[Secobarbital sodium]]  
* [[Trimethoprim]]
* [[Vitamin B12]] deficiency
</div>
</div>


Latest revision as of 13:34, 19 October 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Amandeep Singh M.D.[2] Omer Kamal, M.D.[3]

Overview

The common causes of megaloblastic anemia are less dietray intake, autoimmune disorders like pernicious anemia, alcoholism, increased demands like in pregnancy and due to drugs.

Causes

Common Causes

Common causes of macrocytic anemia may include: causes of megaloblastic anemia and non megaloblastic anemia:[1][2][3]

Megaloblastic

Non megaloblastic

Less Common Causes

Less common causes of macrocytsic anemia include: [4]

Genetic Causes

Causes by Organ System

Cardiovascular No underlying causes
Chemical/Poisoning No underlying causes
Dental No underlying causes
Dermatologic No underlying causes
Drug Side Effect Amobarbital sodium, Cycloserine, Cytarabine, Ethotoin, Folic acid antagonists (methotrexate), Pergolide, Purine antagonists (6-mercaptopurine), Pyrimidine antagonists (cytosine arabinoside), Phenobarbital, Pyrimethamine, Secobarbital sodium, Trimethoprim
Ear Nose Throat No underlying causes
Endocrine Hypothyroidism
Environmental No underlying causes
Gastroenterologic Chronic liver diseases, diverticulosis, fistula, intestinal anastomosis, achlorhydria
Genetic Lesch-Nyhan Syndrome, Methylmalonic aciduria, Orotic aciduria
Hematologic Myelodysplasia, Pernicious anemia, Reticulocytosis
Iatrogenic No underlying causes
Infectious Disease Diphyllobothrium latum
Musculoskeletal/Orthopedic No underlying causes
Neurologic No underlying causes
Nutritional/Metabolic Alcoholism, Folate deficiency,Orotic aciduria, Vitamin B12 deficiency
Obstetric/Gynecologic Pregnancy
Oncologic No underlying causes
Ophthalmologic No underlying causes
Overdose/Toxicity No underlying causes
Psychiatric No underlying causes
Pulmonary No underlying causes
Renal/Electrolyte No underlying causes
Rheumatology/Immunology/Allergy No underlying causes
Sexual No underlying causes
Trauma No underlying causes
Urologic No underlying causes
Miscellaneous No underlying causes

Causes in Alphabetical Order

List the causes of the disease in alphabetical order:

References

  1. ↑ Savage DG, Ogundipe A, Allen RH, Stabler SP, Lindenbaum J (June 2000). "Etiology and diagnostic evaluation of macrocytosis". Am. J. Med. Sci. 319 (6): 343–52. PMID 10875288.
  2. ↑ Nagao T, Hirokawa M (October 2017). "Diagnosis and treatment of macrocytic anemias in adults". J Gen Fam Med. 18 (5): 200–204. doi:10.1002/jgf2.31. PMC 5689413. PMID 29264027.
  3. ↑ Savage DG, Ogundipe A, Allen RH, Stabler SP, Lindenbaum J (June 2000). "Etiology and diagnostic evaluation of macrocytosis". Am. J. Med. Sci. 319 (6): 343–52. PMID 10875288.
  4. ↑ Rosenblatt DS, Whitehead VM (January 1999). "Cobalamin and folate deficiency: acquired and hereditary disorders in children". Semin. Hematol. 36 (1): 19–34. PMID 9930566.

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