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Pathology
Folate required for DNA synthesis
Aetiology
Dietary deficiency/malabsorption, increased utilization in rapid turnover, pregnancy, anti-folate drugs e.g., methotrexate
Signs
Often none, pallor, CHF, peripheral neuropathy, confusion, Sub-acute Combined
Degeneration of spinal cord
Symptoms
Anaemia, neuropathy, bowel disease
Investigations
Bloods: FBC, serum B12 and Folate
Blood Film: Oval macrocytosis, hypersegmented neutrophils
Bone Marrow Biopsy: Serum ferritin, LDH, homocysteine levels
Treatment
Medical: Replace Folic acid only after any B12 deficiency has been corrected
Prognosis
Symptomatic improvement within 24 hours when treated. Overall prognosis is
very good.
Neural tube formation defects in pregnant women, sterility, cardiovascular
disease
Key Facts
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Key Images
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Key References
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