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FOLATE DEFICIENCY ANEMIA

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  1. most often associated with iron deficiency anemia
  2. necessary for closure of neural tube during early fetal development
  3. minimum daily requirement is 0.5 mg
  4. takes approximately 18 weeks of folate deficient diet to produce anemia
  5. leafy green vegetables good source of dietary folate

Etiology
  1. malnutrition
  2. malabsorption (e.g. sprue) c
  3. hronic hemolytic anemia (e.g. SCD)
  4. multiple gestation medications (i.e. phenytoin, trimethoprim-sulfamethoxazole, oral contraceptives)
Complications

  1. maternal: smaller blood volume, nausea, vomiting, anorexia
  2. fetal: NTD in T1, low birth weight, prematurity

Diagnosis

  1. suspect if iron deficiency anemia fails to respond to treatment
  2. CBC, blood film, red blood cell folate levels
  3. megaloblastic anemia and hypersegmented neutrophils on smear
  4. glossitis and skin roughness
  5. NO neurologic symptoms (unlike B12 deficiency)
  6. elevated serum iron and transferrin saturation

Treatment 
  1. 1 mg folic acid PO daily 
  2. 4 mg folic acid per day with past history of neural tube defect

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FOLATE DEFICIENCY ANEMIA FOLATE DEFICIENCY ANEMIA Reviewed by Radiology Madeeasy on January 13, 2011 Rating: 5
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