Ashok Kumar1 , Nutan Singh2 , Shweta Joshi3 , Bindu Deopa4 , Ashish Gupta5
BACKGROUND Megaloblastic Anaemia is a common disease caused by nutritional deficiency and is associated with other nutritional deficiencies; but the exact prevalence of megaloblastic anaemia is still not known. This study was conducted to evaluate its incidence and causes in a tertiary care hospital of Uttarakhand. METHODS This is a retrospective study done at Government Medical College and Susheela Tiwari Memorial Hospital, Haldwani, a tertiary referral center of Kumau region between February 2017 to January 2019 and all cases of moderate to severe anaemia were enrolled for study. Among 150 cases of nutritional anaemia, 25 children (age ranges from 5 months to 15 year) were taken from the records of the hospital. Then we prepared the data with age, gender, nutritional history, signs symptoms, socioeconomic status, complete blood count with general blood picture, bone marrow aspiration, Vit B12 level, serum folate, and liver function test were done. A TLC count less than 4000/mm3 and platelet count less than 150000/mm3 was considered as leucopenia and thrombocytopenia respectively. Cases with macrocytic blood picture were included for further evaluation with bone marrow, Vitamin B12 and folic acid level. The diagnosis of megaloblastic anaemia was established by megaloblastic changes in the bone marrow, low serum B12 (100 fl. Out these enrolled patients, bone marrow biopsy was done in 12 cases to confirm the diagnosis. RESULTS Bimodal distribution was observed with more cases among toddlers & early adolescent females. Most of the cases belonged to low socioeconomic status with poor dietary habits. Regarding clinical presentation, anaemia, neurological manifestation, icterus, hepatosplenomegaly, pigmentation were observed. Generalized weakness & anorexia were the commonest symptoms. CONCLUSIONS Besides its high prevalence in infancy and early childhood group, our study shows significant cases of adolescent females who presented as isolated B12 deficiency. These high-risk populations can be supplemented with B12 under national program along with iron and folate.
