Folate deficiency laboratory findings: Difference between revisions
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* | * [[mean corpuscular volume|ume]][[mean corpuscular hemoglobin|obin]][[platelet|tele]][[Neutrophil granulocyte|Neutrophil gans]] | ||
** | ** | ||
* [[Bone marrow]] (not normally checked in a patient suspected of [[megaloblastic anemia]]) shows megaloblastic [[hyperplasia]]. | * [[Bone marrow]] (not normally checked in a patient suspected of [[megaloblastic anemia]]) shows megaloblastic [[hyperplasia]]. | ||
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'''Blood chemistries will also show:''' | '''Blood chemistries will also show:''' | ||
* Elevated serum LDH and indirect biluribin level | * Elevated serum LDH and indirect biluribin level | ||
* Low serum folate level, usually <2.5ng/ml | * Low serum folate level, usually <2.5ng/ml, suggestive of acute changes in folate level | ||
* Low RBC folate level | * Low RBC folate level, reflect long term folate status | ||
* Increased [[homocysteine]] in [[folate]] deficency | * Increased [[homocysteine]] in [[folate]] deficency | ||
Some investigations done to rule out the other causes of megaloblastic anemia include: | |||
*serum vitamin B12 | |||
*serum iron panel | |||
*plasma or serum methylmalonic acid | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
Revision as of 11:23, 28 January 2019
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Overview
Laboratory Findings
First line investigations include the following:
- Complete blood count:
- Decreased hemoglobin and hematocrit levels
- Increased mean corpuscular volume (MCV >95 fl often >110) and mean corpuscular hemoglobin (MCH)
- Low corrected reticulocyte count which indicates decreased production by the bone marrow.
- The platelet count may be reduced.
- Examination of peripheral blood smear :
- Neutrophil granulocytes may show multisegmented nuclei ("senile neutrophil"), due to decreased production and a compensatory prolonged lifespan for circulating neutrophils.
- Anisocytosis (increased variation in RBC size) and poikilocytosis (abnormally shaped RBCs).
- Macrocytes (larger than normal RBCs) are present.
| Reference Range | |
| Folic Acid in Serum/Plasma Deficiency | 3.6-15 mg/dl |
| Adequate Folic Acid Supply | > 4 ug/l |
| Erythrocyte Folic Acid | 120-800 ug/l |
- umeobinteleNeutrophil gans
- Bone marrow (not normally checked in a patient suspected of megaloblastic anemia) shows megaloblastic hyperplasia.
- Howell-Jolly bodies (chromosomal remnant) also present.
Blood chemistries will also show:
- Elevated serum LDH and indirect biluribin level
- Low serum folate level, usually <2.5ng/ml, suggestive of acute changes in folate level
- Low RBC folate level, reflect long term folate status
- Increased homocysteine in folate deficency
Some investigations done to rule out the other causes of megaloblastic anemia include:
- serum vitamin B12
- serum iron panel
- plasma or serum methylmalonic acid