Macrocytic anemia history and symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
History and Symptoms
- The major manifestations of Folate or B12 deficiency are related to the anemia and gastrointestinal dysfunction. Only B12 deficiency causes neurologic dysfunction. Constitutional symptoms related to anemia such as fatigue, dyspnea, lightheadedess, and anorexia occur. High output cardiac failure and angina are also consequences.
Symptoms mostly related to GI mucosal abnormalities. Tend to be worse in folate rather than B12 deficiency. Diarrhea, cheilosis and glossitis can be noted.
- The classic picture of B12 deficiency is subacute combined degeneration of the dorsal columns. Specific for B12 deficiency, the patient will present with a broad based gait, ataxic, irritable, forgetful with numbness or paresthesias. Rhomberg and Babinski’s can be noted. Dementia may progress to frank “Megaloblastic Madness”. Remember, hematological abnormalities can occur without neurologic manifestations in B12 deficiency.