[Megaloblastic anemia in the elderly]

From 1974 to 1984, the authors reviewed the clinical records of 20 elderly patients (10 male) at the Clinics Hospital of the School of Medicine of the University of São Paulo, who were admitted with megaloblastic anemia. Ages varied from 62 to 84 (mean 70.4 years). Clinical conditions was varied and usually severe, major systems affected being the hematologic, cardiocirculatory, neurologic, and digestive. Among hematological findings the most common were anemia with elevated cell volume, high neutrophil segmentation rate, leukopenia, thrombocytopenia and hemolysis. Pathological findings were present in all cases where endoscopy and gastric biopsy were performed. Clinical and hematological conditions were similar in patients with folic acid or vitamin B12 deficiency. 19 patients (90.0%) responded to therapy in an usually prompt and clear manner, however some neurological signs may persist. On the other hand, untreated patients may become seriously ill and even die due to cardiac, hemorrhagic, or infectious complications.