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Case 280 - Discussion

Uploaded: 2012-10-21, Updated: 2012-10-21


This blood smear shows multilobated neutrophils and macrocytosis. Occasional Howell-Jolly bodies are also present.


Megaloblastic Anemia

  • Vitamin B12 or folate deficiency

  • Peripheral blood: macrocytic anemia, hypersegmented neutrophils

  • Bone marrow: hypercellular marrow with megaloblastic erythroid hyperplasia, giant metamyelocytes. May mimic AML or MDS

  • ↑ Homocysteine in both vitamin B12 and folate deficiency, but ↑methylmalonic acid (MMA) only in B12 deficiency

  • ↑↑ LDH