Pediatric Megaloblastic Anemia Differential Diagnoses
- Author: James L Harper, MD; Chief Editor: Max J Coppes, MD, PhD, MBA more...
Diagnostic Considerations
In a patient with combined folate and vitamin B-12 deficiency, if only the folate deficiency is recognized, folic acid supplementation may be sufficient to drive the production of active 5 methyl tetrahydrofolate (THF) in the absence of vitamin B-12. This results in improvement of the anemia but does not result in improvement of the function of other pathways dependent on B-12.
Clinically, this is apparent as a resolution of megaloblastic anemia, but with progressive dementia and long-tract neurologic deficits. This situation can be avoided by measuring levels of both vitamins, then evaluating and treating both deficiencies, if found.
Other conditions to consider include the following:
- Aplastic anemia
- Celiac disease
- Ecchymoses
- Granulocytopenia
- Hyposplenism
- Myeloproliferative disorders
- Neutropenia
- Pancytopenia
- Tapeworm infection (cestodiasis)
- Imerslund-Grasbeck disease
- Thiamine-responsive megaloblastic anemia[1, 2]
Go to Pediatric Chronic Anemia, Anemia of Prematurity, Donath-Landsteiner Hemolytic Anemia, Pediatric Acute Anemia, and Fanconi Anemia for complete information on these topics.
Differential Diagnoses
- Acute Myelocytic Leukemia
- Anemia, Acute
- Anemia, Chronic
- Bone Marrow Failure
- Hypopituitarism
- Intestinal Protozoal Diseases
- Lymphoproliferative Disorders
- Malabsorption Syndromes
- Malnutrition
- Soy Protein Intolerance
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