Abstract

Kodandaraman Thoti*, Madhavi V. T., Sravya Sruthi P. and Lakshmi P.

ABSTRACT

Megaloblastic anemia is commonly a disease of nutritional deficiency of either vitamin B12 or Folate; or both, inherited disorders of DNA synthesis. Its usual presentations are fatigue, paleness and recurrent infections. It is a rare clinical entity in pediatric age is found most exclusively in breastfed infants. Diagnosis is usually based on complete blood count and peripheral smear which may show significant macrocytosis and a raised mean corpuscular volume (MCV > 100 Fl). Here we report a case of 11 months old female child who presented with complaints of fever, excessive sleep and crying during micturition. Her complete blood picture showed macrocytosis and anisocytosis on peripheral blood smear, and bicytopenia (Decreased Hemoglobin and Platelets) and low reticulocyte count. Hence diagnosis of megaloblastic anemia with accompanying feature of moderate acute malnutrition was made. Taken blood transfusion, Vit B12, Folic Acid and symptomatic treatment, and vitamin supplements. This case shows the severity of vitamin B12 deficiency and suggest that all physicians be aware of megaloblastic anemia as a treatable cause of pyrexia and timely management of these patients.