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Bleeding manifestations in megaloblastic anemia
Indian Journal of Pediatrics
|March 1, 1989
Insights
Megaloblastic anemia in children can cause severe bleeding. Prompt treatment with vitamin B12 or folate effectively restored hemostasis within 24 hours.
Area of Science:
- Pediatric Hematology
- Nutritional Deficiencies
- Hemostasis
Background:
- Megaloblastic anemia is a serious condition in children, often presenting with significant bleeding risks.
- Hemorrhagic diathesis complicates megaloblastic anemia, leading to life-threatening hemorrhages.
- Low platelet counts and severe anemia are common in affected pediatric patients.
Purpose of the Study:
- To report on a cohort of children diagnosed with megaloblastic anemia and associated hemorrhagic diathesis.
- To highlight the clinical presentation, including severity of anemia and thrombocytopenia.
- To evaluate the therapeutic response and time to hemostasis.
Main Methods:
- Retrospective case series of ten pediatric patients.
- Clinical data collection including presenting hemoglobin, platelet counts, and bleeding severity.
- Assessment of response to specific vitamin therapies (B12/folate).
Main Results:
- Ten children presented with megaloblastic anemia and hemorrhagic diathesis.
- Four children experienced life-threatening bleeds requiring emergency transfusion.
- Seven patients had severe thrombocytopenia (<30,000/cu mm), and nine had profound anemia (Hb ≤5.2 g/dl).
- Vitamin B12 deficiency was the more common etiology.
- Excellent therapeutic response observed, with hemostasis achieved within 12-24 hours of treatment initiation.
Conclusions:
- Megaloblastic anemia poses a significant risk of severe hemorrhage in children.
- Early diagnosis and prompt treatment are crucial for managing bleeding complications.
- Vitamin B12 or folate repletion rapidly corrects hemostatic defects in this pediatric population.
Abstract:
Ten children with megaloblastic anemia and a hemorrhagic diathesis are reported. Four of them had life-threatening bleeds necessitating an emergency blood transfusion. Seven had platelet counts of less than 30,000/cu mm, and nine had hemoglobin values of less than or equal to 5.2 g/dl at initial presentation. Deficiency of vitamin B12 was more frequently encountered. Response to therapy was excellent and hemostasis was possible within 12 to 24 hours of initiating treatment.