Macrocytic anemia medical therapy: Difference between revisions
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{{Macrocytic anemia}} | {{Macrocytic anemia}} | ||
{{CMG}} | {{CMG}} | ||
==Overview== | ==Overview== | ||
==Medical Therapy== | |||
== | * [[Folate]] is administered 1mg QD. Higher doses may be required in malabsorptive syndromes. It is empirically given to those with SCD and those on HD. | ||
* Folate is administered 1mg QD. Higher doses may be required in malabsorptive syndromes. It is empirically given to those with SCD and those on HD. | |||
* B12 must be given as a load then maintenance. Most advocate 1000 mcg IM Qweek x4 then 100mcg/month. | * B12 must be given as a load then maintenance. Most advocate 1000 mcg IM Qweek x4 then 100mcg/month. | ||
* LDH falls in 2 days. | * [LDH]] falls in 2 days. [[Hypokalemia]] requiring replacement can occur in the acute phase as new cells are being generated rapidly. | ||
* A reticulocytosis begins in 3-5 days and peaks in 10 days. The HCT will rise within 10days. If it does not, suspect another disorder. Hypersegmented PMNs disappear in 10-14 days. | * A [[reticulocytosis]] begins in 3-5 days and peaks in 10 days. The HCT will rise within 10days. If it does not, suspect another disorder. Hypersegmented PMNs disappear in 10-14 days. | ||
* Neurologic abnormalities may take up to 6 months to resolve if ever. The longer the disease has been present, the worse is the prognosis for recovery. | * Neurologic abnormalities may take up to 6 months to resolve if ever. The longer the disease has been present, the worse is the prognosis for recovery. | ||
* Persons with PA have a 2x risk of gastric CA (in some studies). Screen for occult blood. | * Persons with PA have a 2x risk of gastric CA (in some studies). Screen for occult blood. | ||
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==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
{{WikiDoc Help Menu}} | {{WikiDoc Help Menu}} | ||
{{WikiDoc Sources}} | {{WikiDoc Sources}} | ||
Revision as of 16:48, 21 September 2012
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Medical Therapy
- Folate is administered 1mg QD. Higher doses may be required in malabsorptive syndromes. It is empirically given to those with SCD and those on HD.
- B12 must be given as a load then maintenance. Most advocate 1000 mcg IM Qweek x4 then 100mcg/month.
- [LDH]] falls in 2 days. Hypokalemia requiring replacement can occur in the acute phase as new cells are being generated rapidly.
- A reticulocytosis begins in 3-5 days and peaks in 10 days. The HCT will rise within 10days. If it does not, suspect another disorder. Hypersegmented PMNs disappear in 10-14 days.
- Neurologic abnormalities may take up to 6 months to resolve if ever. The longer the disease has been present, the worse is the prognosis for recovery.
- Persons with PA have a 2x risk of gastric CA (in some studies). Screen for occult blood.