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Acute folate deficiency in a critically ill patient
S E Geerlings1, J H Rommes, D W van Toorn
1Department of Intensive Care, Ziekenhuiscentrum Apeldoorn, The Netherlands.
The Netherlands Journal of Medicine
|July 1, 1997
Summary
Acute folate deficiency can cause low blood counts in critically ill patients, even with normal folate levels. Early folic acid supplementation is crucial for prevention and treatment in these cases.
Area of Science:
- Hematology
- Critical Care Medicine
- Nutritional Science
Background:
- Critically ill patients, especially those with multiple organ failure, are at risk for developing nutritional deficiencies.
- Acute folate deficiency is an underrecognized complication in intensive care settings.
Observation:
- A 19-year-old male recovering from multiple organ failure developed thrombocytopenia and leukopenia.
- These hematological abnormalities were attributed to acute folate deficiency.
Findings:
- Diagnosis of acute folate deficiency can be challenging, presenting with megaloblastic changes in bone marrow despite normal serum and red blood cell folate levels.
- Risk factors include extensive tissue damage (sepsis, trauma, surgery) and acute renal failure requiring renal replacement therapy.
Implications:
- Early recognition and intervention with folic acid therapy are essential to prevent and manage this complication.
- This highlights the importance of nutritional monitoring in critically ill patients.
- Folic acid supplementation should be considered in patients with unexplained cytopenias during critical illness recovery.