In megaloblastic anaemia
, deficiency of either folate or vitamin B12 is associated with increased levels of homocysteine in blood.
Pernicious anaemia is a peculiar type of megaloblastic anaemia
which results from deficiency of Intrinsic Factor.10
Patients with megaloblastic anaemia
and normal HPLC findings, showed significantly higher [HbA.sub.2] levels than the normals as shown earlier (22).
So the causation of megaloblastic anaemia
in malaria remains elusive and can be confirmed by measuring methionine synthase level in blood and peripheral blood smear in chronic asymptomatic cases where sustained NO production is evident.
There are two major clinical syndromes of vitamin B12 deficiency: megaloblastic anaemia
and/or disease of the nervous system, neuropathy.
In megaloblastic anaemia
the morphological changes of megaloblastic maturation in the bone marrow revert to normal within 24-48 hours after cobalamin therapy [15, 18].
This is despite of the fact that a clinician in this country rarely comes across cases of primary vitamin deficiencies like rickets, scurvy, hypo-prothrombinaemia and megaloblastic anaemia
Traditionally basophilic stippling is caused by denatured RNA fragments and associated with heavy metal poisoning, haemoglobinopathies, severe infections, sideroblastic anaemia and megaloblastic anaemia
Ineffective haematopoiesis causes pancytopenia in MDS, histiocytic sarcoma and nonneoplastic aetiologies like megaloblastic anaemia
, immune-mediated destruction of marrow progenitors, drugs and infectious agents.
Other notable signs of anaemia include paleness of skin and mucous membrane Specific features are related to specific causes such as koilonychia in iron deficiency, atrophic glossitis in megaloblastic anaemia
Histopathological analysis of bone marrow trephine biopsies revealed megaloblastic anaemia
as the most common cause of pancytopenia (30%), followed by aplastic anaemia (25%) and hypersplenism (15%).
Prevalence of chronic autoimmune gastritis and pernicious anaemia can be increased up to 5 times in people with T1DM.Patients with T1DM can exhibit auto antibodies to intrinsic factor (AIF) type 1 and 2 and parietal cell antibodies (PCA) especially those with glutamate decarboxylase-65 (GAD-65) antibodies and HLA- DQA10501-B10301 haplotype.12 Depending on extent of deficiency, clinical manifestations can range from impaired memory, dementia, delirium, peripheral neuropathy, sub acute combined degeneration of the spinal cord, megaloblastic anaemia