1/17. Pseudodementia in a twenty-one-year-old with bipolar disorder and vitamin B12 and folate deficiency.A twenty-one-year-old female known to suffer from bipolar type I disorder developed features of a pseudodementia. Following prompt initial response to treatment with antidepressants, there was an early recurrence of cognitive impairment. blood investigations confirmed a macrocytic anaemia and vitamin B12 and folate deficiencies. There was dramatic resolution of cognitive impairment after vitamin replacement. This suggested the occurrence of a reversible nutritional dementia and reinforced the need to rule out secondary organic causes of psychiatric symptoms even in patients previously diagnosed with a primary psychiatric disorder.- - - - - - - - - - ranking = 1keywords = anaemia (Clic here for more details about this article) |
2/17. Reversible central nervous system dysfunction in folate deficiency.An epileptic patient on chronic anticonvulsant drug therapy is described, in whom anaemia and neurological abnormalities including progressive dementia, bilateral pyramidal tract signs, incontinence and ataxia developed. Vitamin B12 serum levels and absorption were normal, but serum folic acid levels were low. Both the neurological disturbances and anaemia resolved following oral folic acid administration. This sequence of events in our patient suggests a cause and effect relationship between the folate deficiency and the coexistent, transient neurological syndrome.- - - - - - - - - - ranking = 2keywords = anaemia (Clic here for more details about this article) |
3/17. iron and vitamin B12 deficiency anaemia in a vegetarian: a diagnostic approach by enzyme-linked immunosorbent assay and radioimmunoassay.This article presents the case of a 46-year-old vegetarian who had a painful dry socket in the left third molar areas. Since the patient's general appraisal was anaemic, investigations for haematological status, folic acid and vitamin B12 were performed. The results revealed that the patient was severely iron deficient and slightly vitamin B12 deficient.- - - - - - - - - - ranking = 4keywords = anaemia (Clic here for more details about this article) |
4/17. Dietary folate deficiency with normal red cell folate and circulating blasts.This report describes a 26 year old woman, of Pakistani origin, who presented five months postpartum with severe megaloblastic anaemia as a result of nutritional folate deficiency. This case was unusual in that a small number of myeloblasts were present in the peripheral blood at presentation, and this circulating population temporarily increased in size when folate replacement was begun. We also highlight the need to recognise the non-linear relation between haematocrit and red blood cell folate concentration when the haematocrit is very low (< 0.15) and emphasise the importance of the clinical history.- - - - - - - - - - ranking = 1keywords = anaemia (Clic here for more details about this article) |
5/17. sarcoidosis: association with small bowel disease and folate deficiency.A 30 year old woman with recurrent anaemia due to folate deficiency had evidence of sarcoid granuloma on small bowel biopsy but was presumed to have Crohn's disease. The diagnosis of small bowel sarcoidosis was not seriously considered until she developed systemic manifestations of sarcoidosis (cutaneous and pulmonary lesions) over the following 20 years. sarcoidosis of the gastrointestinal tract, particularly the small bowel, is rare and this case is unusual because bowel pathology preceded more generalised lesions. As far as is known it is also the first case to be described presenting with malabsorption of folic acid.- - - - - - - - - - ranking = 1keywords = anaemia (Clic here for more details about this article) |
6/17. Severe folate deficiency in pregnancy with normal red cell folate level.We report here a case of megaloblastic anaemia in late pregnancy, which leads us to question whether folate supplements should be recommended in the UK routinely throughout pregnancy and not just in the preconception period and first trimester.- - - - - - - - - - ranking = 1keywords = anaemia (Clic here for more details about this article) |
7/17. A patient with megaloblastic anaemia and idiopathic intracranial hypertension. Case history.A young woman with idiopathic intracranial hypertension (IIH) was found to have a severe megaloblastic anaemia due to multiple alimentary vitamin deficiencies. After correction of the anaemia the idiopathic intracranial hypertension disappeared.- - - - - - - - - - ranking = 6keywords = anaemia (Clic here for more details about this article) |
8/17. Megaloblastic anaemia in an elderly patient treated with triamterene.The case is presented of an elderly woman in whom megaloblastic anaemia due to folate deficiency was diagnosed. It is speculated that this disorder was induced by treatment with triamterene.- - - - - - - - - - ranking = 5keywords = anaemia (Clic here for more details about this article) |
9/17. Megaloblastic anaemia due to sulphasalazine responding to drug withdrawal alone.A 60 year old man with ulcerative colitis since 1975 and treated with sulphasalazine, presented with severe megaloblastic anaemia caused by folate deficiency. The drug was stopped, and the anaemia recovered promptly. There was no relapse one year later.- - - - - - - - - - ranking = 6keywords = anaemia (Clic here for more details about this article) |
10/17. Sulphasalazine associated pancytopenia may be caused by acute folate deficiency.agranulocytosis and aplastic anaemia associated with sulphasalazine are well recognised, but pancytopenia caused by acute megaloblastic arrest of haemopoiesis while taking sulphasalazine has not previously been described. We report three patients who, after taking sulphasalazine for over two years, suddenly developed severe pancytopenia with gross megaloblastic changes in the marrow. In two patients there was a good response to high dose oral folic acid but the third required folinic acid. The mechanism appears to be acute folate deficiency, and the requirement for folinic acid in one case suggests that the known inhibition of folate metabolism by sulphasalazine also contributes. The syndrome appears to be associated with high dosage and slow acetylator status. The drug has been successfully restarted at reduced dosage with folate supplements in two patients both of whom were slow acetylators. In the third case, whose acetylator status is not known, progression of her disease led to colectomy.- - - - - - - - - - ranking = 1keywords = anaemia (Clic here for more details about this article) |
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