Pediatric Megaloblastic Anemia Medication
- Author: James L Harper, MD; Chief Editor: Max J Coppes, MD, PhD, MBA more...
Medication Summary
The 2 most common causes of megaloblastic anemia are vitamin B-12 (cobalamin) deficiency and folinic acid deficiency. Treatment may require supplemental administration of these vitamins.
Vitamins
Class Summary
Vitamins are organic substances required by the body in small amounts for various metabolic processes. Vitamins may be synthesized in small or insufficient amounts in the body or not synthesized at all, thus requiring supplementation. Use folic acid and vitamin B-12 supplements as indicated.
Folic acid (Folacin-800)
A member of the vitamin B group, folic acid is reduced in the body to 5 methyl tetrahydrofolate (THF), which is a coenzyme for various metabolic processes including purine and pyrimidine nucleotides synthesis essential for DNA. Folic acid is an important cofactor for enzymes used in production of red blood cells.
Cyanocobalamin (CaloMist, Nascobal, Ener-B)
Deoxyadenosylcobalamin and hydroxocobalamin are active forms of vitamin B-12 in humans. Vitamin B-12 is synthesized by microbes but not humans or plants. Vitamin B-12 deficiency may result from inadequate dietary intake, intrinsic factor deficiency (pernicious anemia), partial or total gastrectomy, or diseases of the distal ileum.
Lorber A, Gazit AZ, Khoury A, Schwartz Y, Mandel H. Cardiac manifestations in thiamine-responsive megaloblastic anemia syndrome. Pediatr Cardiol. Sep-Oct 2003;24(5):476-81. [Medline].
Olsen BS, Hahnemann JM, Schwartz M, Østergaard E. Thiamine-responsive megaloblastic anaemia: a cause of syndromic diabetes in childhood. Pediatr Diabetes. Aug 2007;8(4):239-41. [Medline].
Whitehead VM. Acquired and inherited disorders of cobalamin and folate in children. Br J Haematol. Jul 2006;134(2):125-36. [Medline].
Korenke GC, Hunneman DH, Eber S, Hanefeld F. Severe encephalopathy with epilepsy in an infant caused by subclinical maternal pernicious anaemia: case report and review of the literature. Eur J Pediatr. Apr 2004;163(4-5):196-201. [Medline].
Molloy AM, Kirke PN, Brody LC, Scott JM, Mills JL. Effects of folate and vitamin B12 deficiencies during pregnancy on fetal, infant, and child development. Food Nutr Bull. Jun 2008;29(2 Suppl):S101-11; discussion S112-5. [Medline].
Erkurt MA, Aydogdu I, Dikilitas M, Kuku I, Kaya E, Bayraktar N, et al. Effects of cyanocobalamin on immunity in patients with pernicious anemia. Med Princ Pract. 2008;17(2):131-5. [Medline].
Dror DK, Allen LH. Effect of vitamin B12 deficiency on neurodevelopment in infants: current knowledge and possible mechanisms. Nutr Rev. May 2008;66(5):250-5. [Medline].
Dugué B, Ismail E, Sequeira F, Thakkar J, Gräsbeck R. Urinary excretion of intrinsic factor and the receptor for its cobalamin complex in Gräsbeck-Imerslund patients: the disease may have subsets. J Pediatr Gastroenterol Nutr. Aug 1999;29(2):227-30. [Medline].

