What Is Macrocytic Anemia?

Vegetative megaloblastic anemia, also known as trophic large cell anemia, shows large cells under the microscope, positive pigment. More common in infants and young children, especially under 2 years old.

Large cell anemia

Large cell anemia concept

Vegetative megaloblastic anemia, also known as trophic large cell anemia, shows large cells under the microscope, positive pigment. More common in infants and young children, especially under 2 years old.

Causes of large cell anemia

What causes nutritional megaloblastic anemia?

Mainly due to lack of vitamin B12 or folic acid

(A) insufficient intake.

(2) Barriers to absorption and utilization.

(3) Increased demand.

(4) Insufficient storage.

(E) Acute blood loss.

Symptoms and clinical manifestations of large cell anemia

What are the symptoms of trophic megaloblastic anemia

Slow onset, more common in infants and young children, especially children under 2 years old. Folic acid deficiency occurs in 4-7 months, while vitamin B12 deficiency develops in 6 months. Among them, those who only breastfeed without supplementary food account for the vast majority.

The main clinical manifestations are as follows:

(A) general performance: mostly puffy body or mild edema, thinning hair, yellowing, and occasionally skin bleeding points.

(2) Anemia manifestation: Mild or moderate anemia accounts for the majority, with a pale complexion and fatigue. Hematopoietic reactions outside the bone marrow are caused by anemia, and there is a three-line reduction phenomenon, so it is often accompanied by enlarged liver, spleen, and lymph nodes.

(3) Mental and neurological symptoms: dull expression, drowsiness, slow response to the outside world, crying less or not crying, retarded mental and motor development, and even retrogression, such as the original recognition, crawling, etc., will not be after illness In addition, there are still uncoordinated and involuntary movements, limbs, head, tongue and even whole body tremors, increased muscle tone, hypertenoid reflexes, positive ankle clonics, superficial reflexes disappeared, and even convulsions.

(IV) Symptoms of digestive system: loss of appetite, glossitis, sublingual ulcers, diarrhea, etc.

Examination and treatment of large cell anemia

What inspections are needed for trophic megaloblastic anemia?

(1) Blood routine.

There are fewer red blood cells, the central pale staining area is not obvious, the staining is deep, and the size is slightly uneven. Occasionally, young red blood cells are seen. Polychromatic and basophilic stippled red blood cells can be seen. Howell's body and Kaposi's can also be seen. ring. The number of white blood cells is slightly lower.

(B) Bone marrow image.

Bone marrow hyperplasia is active, with erythrocyte hyperplasia as the main component, and the ratio of grains and red is normal or inverted. The red blood cell lines are all bulky.

(3) Blood biochemical examination.

1. Determination of serum vitamin B12 content, the normal value is 200-800pg / ml. Such as <100pg / ml suggest vitamin B12 deficiency.

2. Determination of serum folate content, the normal value is 5-6ng / ml. <3ng / ml indicates folic acid deficiency.

How to treat it?

(1) General treatment and diet improvement: If breastfeeding infants, dietary nutrition of nursing mothers should be improved. Infants must also be supplemented with food, weaned on time, and correct partial eclipse habits. Actively prevent and treat respiratory and digestive diseases.

(2) Drug treatment.

The main application of vitamin B12 is 100 g / times intramuscular injection twice a week for 2-4 weeks until the reticulocytes are normal and can be supplemented with supplementary food.

For those who are deficient in folic acid. Oral folic acid 5mg 3 times a day, after 2 weeks, it can be changed once a day. Vitamin C can promote the use of folic acid and can be taken orally at the same time to improve the efficacy.

At present, it is advocated that vitamin B12 and folic acid are used in combination with vitamin C, which can improve the efficacy.