Macrocytic anemia causes
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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 macrocytic anemia may include: causes of megaloblastic anemia and non megaloblastic anemia:[1][2][3]
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
- Alcoholism
- 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.
Non megaloblastic
Less Common Causes
Less common causes of macrocytsic anemia include:
- 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
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 | Hypothyroidism |
| Environmental | No underlying causes |
| Gastroenterologic | Chronic liver diseases, diverticulosis, fistula, intestinal anastomosis, achlorhydria |
| Genetic | Lesch-Nyhan Syndrome |
| 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, 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:
- Alcoholism
- Amobarbital sodium
- Chronic liver diseases
- Cycloserine
- Cytarabine
- Diphyllobothrium latum
- Ethotoin
- Folate deficiency
- Folic acid antagonists (methotrexate)
- Hypothyroidism
- Lesch-Nyhan Syndrome
- Myelodysplasia
- Pergolide
- Pernicious anemia
- Purine antagonists (6-mercaptopurine)
- Pyrimidine antagonists (cytosine arabinoside)
- Phenobarbital
- Pregnancy
- Pyrimethamine
- Reticulocytosis
- Secobarbital sodium
- Vitamin B12 deficiency
References
- ↑ 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.
- ↑ 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.
- ↑ 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.