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Diagnosis Of Megaloblastic Anemia - Quick Bites Internal medicine (Hematology)
Medical History: A thorough medical history is essential, including questions about symptoms, family history, dietary habits, and any underlying medical conditions or medications that may contribute to megaloblastic anemia.
Physical Examination: The healthcare provider may conduct a physical examination to look for signs of anemia, such as pale skin, fatigue, and an enlarged spleen.
Complete Blood Count (CBC): A CBC is a blood test that measures various components of blood, including red blood cell (RBC) count, hemoglobin levels, hematocrit, and mean corpuscular volume (MCV). In megaloblastic anemia, the MCV is typically elevated, indicating larger-than-normal red blood cells.
Peripheral Blood Smear: A peripheral blood smear involves examining a small sample of blood under a microscope. It helps identify abnormal RBC shapes (macro-ovalocytes) and increased numbers of immature red blood cells (megaloblasts).
Serum Folate and Vitamin B12 Levels: Blood tests for serum folate and vitamin B12 levels can help determine the underlying cause of megaloblastic anemia. Low levels of either nutrient may indicate a deficiency.
Serum Homocysteine and Methylmalonic Acid Levels: These blood tests can further confirm vitamin B12 deficiency. Elevated levels of homocysteine and methylmalonic acid are indicative of such deficiency.
Bone Marrow Aspiration and Biopsy: In some cases, a bone marrow aspiration and biopsy may be performed to assess the appearance of the bone marrow and evaluate the production of red blood cells. It can help differentiate between different types of megaloblastic anemias.
Intrinsic Factor Antibody Test: This test is specifically used to diagnose pernicious anemia, an autoimmune condition where the body does not produce intrinsic factor, which is necessary for vitamin B12 absorption. Presence of intrinsic factor antibodies is indicative of this condition.
Schilling Test: While less commonly used today, the Schilling test used to be employed to assess vitamin B12 absorption. It helps diagnose pernicious anemia and other causes of vitamin B12 deficiency.
Underlying Cause Evaluation: Depending on the results of initial tests, further investigations may be needed to identify the underlying cause of megaloblastic anemia, such as autoimmune disorders, malabsorption syndromes, or dietary deficiencies.
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