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Megaloblastic anemia is a blood disorder in which there is anemia with larger-than-normal red blood cells.

Megaloblastic anemia is usually caused by a deficiency of folic acid or vitamin B12. Other causes are:

• Alcohol abuse
• Certain inherited disorders
• Drugs that affect DNA, such as chemotherapy drugs
• Leukemia
• Myelodysplastic syndrome
• Myelofibrosis

Risk factors relate to the causes.

See also: Pernicious anemia

• Change in skin color
• Diarrhea
• Headaches
• Loss of appetite
• Pale skin color
• Sore mouth and tongue
• Tingling and numbness of hands and feet
• Tiredness

Examination of the nervous system may show:

• Abnormal reflexes
• Decreased sense of position
• Decreased sense of vibration
• Serum ferritin Tests include:

• Bone marrow examination
• Complete blood count
• Schilling test
• Serum B12 level
• Serum folate level
• Serum methylmalonic acid

The first goal is to diagnose the cause of the anemia. The treatment depends on the cause. Anemias related to specific vitamin deficiencies are discussed separately.

The outcome depends on the cause of the anemia.

Complications vary with the cause of the anemia.

Call for an appointment with your health care provider if you develop symptoms of this condition.

Getting enough vitamin B12 and folic acid is helpful.

Anemia - megaloblastic

Antony AC. Megoblastic anemias. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 170.

Updated by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.