Clinical and sociodemographic characteristics in patients with megaloblastic anemia. Hospitals of San José and children's school of San José

Características clínicas y sociodemográficas en pacientes con anemia megaloblástica. Hospitales de San José e infantil universitario de San José

Deficiency of vitamin B 12 is the most frequent cause of anemia after the origin of iron deficiency. Objective: to establish the sociodemographic and clinical profile in megaloblastic anemia. Materials and methods: series of patients hospitalized with megaloblastic anemia between January 2010 and December 2011 in the San José and Infant University hospitals of San José, Bogotá DC. Results: 17 cases, 11 in men. Average age 59 years (DE: 15.8 years, range: 37-82), 88% married, stratum two 76.4%, pensioners 17%, with income of two legal minimum wages in force 94.1% monthly and live with more than two people 75.4% . Seven patients (41.1%) with a combined deficit of folic acid and vitamin B12, of vitamin B 12 three (17.6%) and of folic acid two (14.2%). The most frequent manifestations were anorexia (70.5%), dry skin (62.5%), atrophic glossitis (29.4%) and jaundice (23.5%). Association with autoimmune disease was observed in 17.6%, neoplasias of non-haematological origin 11.7% and chronic alcohol consumption 35.3%. Conclusion: the majority belonged to low socioeconomic status, with limited income and families made up of more than two people. The most frequent manifestations were digestive, dermatological and neurological. A combined deficit of vitamin B12 and folic acid was found, exclusive of folic acid associated with chronic alcohol consumption and only of vitamin B 12. Abbreviations: AM, megaloblastic anemia.

1 De Paz R, Hernandez-Navarro F. Manejo, prevención y control de la anemia megaloblástica secundaria a déficit de ácido fólico. Nutr. Hosp. 2006 Ene-Feb. 21(1): 113-9.

2 Andres E, Loukili NH, Noel E, Kaltenbach G, Abdelgheni MB, Perrin AE, et al. Vitamin B12 (cobalamin) deficiency in elderly patients. CMAJ 2004;171(3):251-9.

3 Babior B. Folate, cobalamin, and megaloblastic anemias. In: Lichtman MA, Kipps TJ, Seligsohn U, Kaushansky K, Prchal JT, editors. Williams Hematology. 7th ed. New York, McGraw-Hill; 2006. p. 477–509.

4 Chaney SG. Macronutrients: metabolic effects and health Implications. In: Devlin TM. Text of Biochemistry with clinical correlation. 5th ed. New York: Wiley; 2004. p. 1154-7.

5 Binder RA. Nutrient digestion and absorption. In: Boron WF, Boulpaep EL, editors. Medical Physiology: a cellular and molecular approach. 2nd ed. Philadelphia : Saunders : Elsevier;2009. p. 968-76.

6 Babior B, Bunn H. Megaloblastic anemias. In: Kasper DL, et al, editors. Harrison’s principles of internal medicine. 16th ed. New York: McGraw-Hill; 2005. pp. 601–07.

7 Anemia megaloblástica y otras causas de macrocitosis. En: Sans-Sabrafen J. Hematologia clínica. 5a ed. Madrid, España: Elsevier;2006. p. 163-86.

8 Dali-Youcef N, Andrès E. An update on cobalamin deficiency in adults. QJM. 2009; 102(1):17-28.

9 Lahner E, Annibale B. Pernicious anemia: new insights from a gastroenterological point of view. World J Gastroenterol. 2009; 15(41):5121-8.

10 Kaferle J, Strzoda CE. Evaluation of macrocytosis. Am Fam Physician. 2009; 79(3):203-8.

11 Shah A. Megaloblastic anemia--Part II. Indian J Med Sci. 2004 Jul;58(7):309-11.

12 Antony A. Megaloblastic anemias. In: Hoffman R, et al. edit. Hoffman: hematology: basic principles and practice. 6th ed. Philadelphia, Saunders: Elsevier; 2012.

13 Kaferle J. Evaluation of macrocitosis. Am Fam Phys. 2009; 79(3): 203-8.

14 Cattan D. Pernicious anemia: what are the actual diagnosis criteria?. World J Gastroenterol. 2011; 17(4):543-4.

15 Chan JC, Liu HS, Kho BC, Chu RW, Ma ES, Ma KM, et al. Megaloblastic anaemia in Chinese patients: a review of 52 cases. Hong Kong Med J. 1998 Sep; 4(3):269-74.

16 Langan RC, Zawistoski KJ. Update on Vitamin B12 Deficiency. Am Fam Physician. 2011 Jun 15; 83(12):1425-30.