Megaloblastic Anemia

The most common cause of megaloblastic anemia is deficiency of Vitamin B12 or folate. Its diagnosis is challenging, and for effective management, it is important to differentiate it from the other conditions which present with macrocytic anemia such as myelodysplasia, liver disease, hypothyroidism, etc. In this chapter, a clinical case scenario is presented followed by a step-by-step evidence-based approach to utilize specialized and advanced tests to unravel final diagnosis of megaloblastic anemia. A comprehensive description of pathophysiology of disease, the sensitivity and specificity of anti-intrinsic factor and anti-parietal cell antibodies, situations under which methylmalonyl-CoA (MMA) and homocysteine (HC) tested, importance of the transcobalamins in B12 metabolism and tests to monitor response to B12 therapy are discussed in question–answer format. Salient points are summarized for quick revision? To gain expertise on this topic and enhance your skills for effective planning of management, read this chapter on megaloblastic anemia.