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Bleeding manifestations in megaloblastic anemia.

R K Marwaha, S Singh, G Garewal

    Indian Journal of Pediatrics
    |March 1, 1989
    PubMed
    Summary

    Megaloblastic anemia in children can cause severe bleeding. Prompt treatment with vitamin B12 or folate effectively restored hemostasis within 24 hours.

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    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.

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