Megaloblastic Anemia


Heterogeneous group of disorders with common morphologic characteristics. The morphological hallmark of megaloblastosis is the megaloblast but megaloblastic changes are not limited to erythroid components. For example, hypersegmented neutrophils can be seen on peripheral blood smears and pancytopenia can occur.

Signs & Symptoms

Generalised tiredness, glossitis.

Risk Factors

Usually individuals older than 40 years; prevalence increases in older populations.


Vitamin B12 or Folate deficiency.


Impaired DNA synthesis due to lack of essential factors.

Peripheral blood characteristics

Macrocytic cells and hypersegmented neutrophils.

BM characteristics

Hyperplasia with erythroid dysplasia.

Important investigations & related results

Low serum cobalamin and red blood cell folate levels.

Treatment & management

Cobalamin and folate therapy.

Anisopoikilocytic macrocytic normochromic cells in the peripheral blood smear and hypersegmented neutrophils.

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