Megaloblastic Anemias: Nutritional and Other Causes

Ralph Green, Ananya Datta Mitra

Research output: Contribution to journalReview articlepeer-review

56 Scopus citations


Vitamin B12 and folate deficiencies are major causes of megaloblastic anemia. Causes of B12 deficiency include pernicious anemia, gastric surgery, intestinal disorders, dietary deficiency, and inherited disorders of B12 transport or absorption. The prevalence of folate deficiency has decreased because of folate fortification, but deficiency still occurs from malabsorption and increased demand. Other causes include drugs and inborn metabolic errors. Clinical features of megaloblastic anemia include anemia, cytopenias, jaundice, and megaloblastic marrow morphology. Neurologic symptoms occur in B12 deficiency, but not in folate deficiency. Management includes identifying any deficiency, establishing its cause, and replenishing B12 or folate parenterally or orally.

Original languageEnglish (US)
Pages (from-to)297-317
Number of pages21
JournalMedical Clinics of North America
Issue number2
StatePublished - Mar 1 2017


  • Anemia
  • Folate
  • Homocysteine
  • Megaloblastic
  • Methylmalonic acid
  • Pernicious anemia
  • Transcobalamin
  • Vitamin B

ASJC Scopus subject areas

  • Medicine(all)


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