🧬 Chapter 503 · Megaloblastic Anemias

Nelson Textbook of Pediatrics 22nd Edition | Folate and Vitamin B12 deficiency. Macrocytic anemia, hypersegmented neutrophils, elevated LDH, ineffective erythropoiesis. Causes: poor intake (goat's milk, vegan), malabsorption (pernicious anemia, IF deficiency, Imerslund-Gräsbeck), inborn errors (MTHFR, transcobalamin).

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📋 30 Clinical Scenarios — Megaloblastic Anemias (Folate & B12 Deficiency)

📇 High‑Yield Review Cards (Megaloblastic Anemias)

🩺 Clinical Recognition: Megaloblastic Anemia in Children

Select a presentation for diagnostic clues and management.

📋 Stepwise Management of Folate & B12 Deficiency

🔑 Key Diagnostic Pearls (Nelson Ch 503)
• Macrocytic anemia + hypersegmented neutrophils → suspect B12 or folate deficiency.
• Elevated methylmalonic acid (MMA) → specific for B12 deficiency.
• Elevated homocysteine → both B12 and folate deficiency.
• Schilling test (historical) — replaced by antibody testing (IF antibodies, parietal cell) and genetic studies.

    ⚡ Reflex Prompts — Clinical Decisions in Megaloblastic Anemia

    📖 Summary: Megaloblastic Anemias — Nelson Ch 503