Macrocytic anemia causes: Difference between revisions
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==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 | 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) | :* Nutritional defects (folic acid or vitamin B12 which is mainly from animal sources; [[vegan]]s may require supplementation) | ||
:* Chronic liver diseases | :* Chronic liver diseases | ||
Line 55: | Line 23: | ||
===Common Causes=== | ===Common Causes=== | ||
Common causes of | Common causes of macrocytsic anemia may include: causes of megaloblastic anemia and non megaloblastic anemia: | ||
==== Megaloblastic ==== | |||
** Vitamin B12 Deficiency: | |||
*# Deficient intake | |||
*# Deficient intrinsic factor ([[pernicious anaemia]] or [[gastrectomy]]) | |||
*[ | *# Bilogical competition for B12 by [[diverticulosis]], [[fistula]], intestinal [[anastomosis]], [[achlorhydria]] and infection by the marine parasite ''Diphyllobothrium latum'' | ||
*[ | *# Selective B12 malabsorption (congenital and drug-induced) | ||
*# Chronic [[pancreatitis]] | |||
*# Ileal resection and bypass | |||
** Folate Deficiency: | |||
*# Deficient intake. | |||
*# Increased needs: [[pregnancy]], [[infant]], rapid cellular proliferation, and [[cirrhosis]] | |||
*# Malabsorption (congenital and drug-induced) | |||
*# Intestinal and jejunal resection Toxins and Drugs: | |||
** [[Amobarbital sodium]] | |||
** [[Cycloserine]] | |||
** [[Cytarabine]] | |||
** [[Ethotoin]] | |||
** [[Folic acid]] antagonists ([[methotrexate]]) | |||
** [[Pergolide]] | |||
** [[Purine]] antagonists ([[6-mercaptopurine]]) | |||
** [[Pyrimidine]] antagonists (cytosine arabinoside) | |||
** [[Phenobarbital]] | |||
** [[Pyrimethamine]] | |||
** [[Secobarbital sodium]] | |||
** [[Erythroleukemia]]. | |||
===Less Common Causes=== | ===Less Common Causes=== | ||
Less common causes of [ | Less common causes of | ||
* Combined Dieficiency (Tropical Sprue): Vitamin B12 & Folate. | |||
*[ | * Inherited [[DNA]] Synthesis Disorders: Deficient [[thiamine]] and factors (e.g. enzymes) responsible for folate metabolism. | ||
* | ** [[Lesch-Nyhan Syndrome]] | ||
** | |||
===Genetic Causes=== | ===Genetic Causes=== | ||
*[ | ** [[Lesch-Nyhan Syndrome]] | ||
** | |||
===Causes by Organ System=== | ===Causes by Organ System=== | ||
{|style="width:80%; height:100px" border="1" | {| style="width:80%; height:100px" border="1" | ||
| | | style="width:25%" bgcolor="LightSteelBlue" ; border="1" |'''Cardiovascular''' | ||
| | | style="width:75%" bgcolor="Beige" ; border="1" | No underlying causes | ||
|- | |- | ||
|bgcolor="LightSteelBlue"| '''Chemical/Poisoning''' | | bgcolor="LightSteelBlue" | '''Chemical/Poisoning''' | ||
|bgcolor="Beige"| No underlying causes | | bgcolor="Beige" | No underlying causes | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Dental''' | | '''Dental''' | ||
|bgcolor="Beige"| No underlying causes | | bgcolor="Beige" | No underlying causes | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Dermatologic''' | | '''Dermatologic''' | ||
|bgcolor="Beige"| No underlying causes | | bgcolor="Beige" | No underlying causes | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Drug Side Effect''' | | '''Drug Side Effect''' | ||
|bgcolor="Beige"| | | 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="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Ear Nose Throat''' | | '''Ear Nose Throat''' | ||
|bgcolor="Beige"| No underlying causes | | bgcolor="Beige" | No underlying causes | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Endocrine''' | | '''Endocrine''' | ||
|bgcolor="Beige"| No underlying causes | | bgcolor="Beige" | No underlying causes | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Environmental''' | | '''Environmental''' | ||
|bgcolor="Beige"| No underlying causes | | bgcolor="Beige" | No underlying causes | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Gastroenterologic''' | | '''Gastroenterologic''' | ||
|bgcolor="Beige"| | | bgcolor="Beige" | [[Chronic liver disease|Chronic liver diseases]], [[diverticulosis]], [[fistula]], intestinal [[anastomosis]], [[achlorhydria]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Genetic''' | | '''Genetic''' | ||
|bgcolor="Beige"| | | bgcolor="Beige" |[[Lesch-Nyhan Syndrome]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Hematologic''' | | '''Hematologic''' | ||
|bgcolor="Beige"| No underlying causes | | bgcolor="Beige" | No underlying causes | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Iatrogenic''' | | '''Iatrogenic''' | ||
|bgcolor="Beige"| No underlying causes | | bgcolor="Beige" | No underlying causes | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Infectious Disease''' | | '''Infectious Disease''' | ||
|bgcolor="Beige"| | | bgcolor="Beige" | ''[[Diphyllobothrium latum]]'' | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Musculoskeletal/Orthopedic''' | | '''Musculoskeletal/Orthopedic''' | ||
|bgcolor="Beige"| No underlying causes | | bgcolor="Beige" | No underlying causes | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Neurologic''' | | '''Neurologic''' | ||
|bgcolor="Beige"| No underlying causes | | bgcolor="Beige" | No underlying causes | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Nutritional/Metabolic''' | | '''Nutritional/Metabolic''' | ||
|bgcolor="Beige"| No underlying causes | | bgcolor="Beige" | No underlying causes | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Obstetric/Gynecologic''' | | '''Obstetric/Gynecologic''' | ||
|bgcolor="Beige"| | | bgcolor="Beige" | [[Pregnancy]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Oncologic''' | | '''Oncologic''' | ||
|bgcolor="Beige"| No underlying causes | | bgcolor="Beige" | No underlying causes | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Ophthalmologic''' | | '''Ophthalmologic''' | ||
|bgcolor="Beige"| No underlying causes | | bgcolor="Beige" | No underlying causes | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Overdose/Toxicity''' | | '''Overdose/Toxicity''' | ||
|bgcolor="Beige"| No underlying causes | | bgcolor="Beige" | No underlying causes | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Psychiatric''' | | '''Psychiatric''' | ||
|bgcolor="Beige"| No underlying causes | | bgcolor="Beige" | No underlying causes | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Pulmonary''' | | '''Pulmonary''' | ||
|bgcolor="Beige"| No underlying causes | | bgcolor="Beige" | No underlying causes | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Renal/Electrolyte''' | | '''Renal/Electrolyte''' | ||
|bgcolor="Beige"| No underlying causes | | bgcolor="Beige" | No underlying causes | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Rheumatology/Immunology/Allergy''' | | '''Rheumatology/Immunology/Allergy''' | ||
|bgcolor="Beige"| No underlying causes | | bgcolor="Beige" | No underlying causes | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Sexual''' | | '''Sexual''' | ||
|bgcolor="Beige"| No underlying causes | | bgcolor="Beige" | No underlying causes | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Trauma''' | | '''Trauma''' | ||
|bgcolor="Beige"| No underlying causes | | bgcolor="Beige" | No underlying causes | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Urologic''' | | '''Urologic''' | ||
|bgcolor="Beige"| No underlying causes | | bgcolor="Beige" | No underlying causes | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Miscellaneous''' | | '''Miscellaneous''' | ||
|bgcolor="Beige"| No underlying causes | | bgcolor="Beige" | No underlying causes | ||
|- | |- | ||
|} | |} | ||
===Causes in Alphabetical Order=== | ===Causes in Alphabetical Order=== | ||
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;"> | ||
* | * [[Alcoholism]] | ||
* [[Amobarbital sodium]] | |||
* [[Amobarbital sodium|Chronic liver diseases]] | |||
* [[Cycloserine]] | |||
* [[Cytarabine]] | |||
* ''[[Diphyllobothrium latum]]'' | |||
* [[Ethotoin]] | |||
* [[Folic acid]] antagonists ([[methotrexate]]) | |||
* [[Lesch-Nyhan Syndrome]] | |||
* [[Pergolide]] | |||
* [[Purine]] antagonists ([[6-mercaptopurine]]) | |||
* [[Pyrimidine]] antagonists (cytosine arabinoside) | |||
* [[Phenobarbital]] | |||
* [[Pyrimethamine]], | |||
* [[Secobarbital sodium]] | |||
</div> | </div> | ||
Revision as of 21:22, 20 August 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
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; vegans 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
- 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 of macrocytsic anemia may include: causes of megaloblastic anemia and non megaloblastic anemia:
Megaloblastic
- Vitamin B12 Deficiency:
- Deficient intake
- Deficient intrinsic factor (pernicious anaemia or gastrectomy)
- Bilogical competition for B12 by diverticulosis, fistula, intestinal anastomosis, achlorhydria and infection by the marine parasite Diphyllobothrium latum
- Selective B12 malabsorption (congenital and drug-induced)
- Chronic pancreatitis
- Ileal resection and bypass
- Folate Deficiency:
- Deficient intake.
- Increased needs: pregnancy, infant, rapid cellular proliferation, and cirrhosis
- Malabsorption (congenital and drug-induced)
- Intestinal and jejunal resection Toxins and Drugs:
- Amobarbital sodium
- Cycloserine
- Cytarabine
- Ethotoin
- Folic acid antagonists (methotrexate)
- Pergolide
- Purine antagonists (6-mercaptopurine)
- Pyrimidine antagonists (cytosine arabinoside)
- Phenobarbital
- Pyrimethamine
- Secobarbital sodium
- Erythroleukemia.
Less Common Causes
Less common causes of
- Combined Dieficiency (Tropical Sprue): Vitamin B12 & Folate.
- Inherited DNA Synthesis Disorders: Deficient thiamine and factors (e.g. enzymes) responsible for folate metabolism.
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 |
Ear Nose Throat | No underlying causes |
Endocrine | No underlying causes |
Environmental | No underlying causes |
Gastroenterologic | Chronic liver diseases, diverticulosis, fistula, intestinal anastomosis, achlorhydria |
Genetic | Lesch-Nyhan Syndrome |
Hematologic | No underlying causes |
Iatrogenic | No underlying causes |
Infectious Disease | Diphyllobothrium latum |
Musculoskeletal/Orthopedic | No underlying causes |
Neurologic | No underlying causes |
Nutritional/Metabolic | No underlying causes |
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:
- Alcoholism
- Amobarbital sodium
- Chronic liver diseases
- Cycloserine
- Cytarabine
- Diphyllobothrium latum
- Ethotoin
- Folic acid antagonists (methotrexate)
- Lesch-Nyhan Syndrome
- Pergolide
- Purine antagonists (6-mercaptopurine)
- Pyrimidine antagonists (cytosine arabinoside)
- Phenobarbital
- Pyrimethamine,
- Secobarbital sodium