Folate Deficiency Anemia
by Allison Wang
1. Causative factors
1.1. Alcohol consumption, tobacco Smoking
1.2. Bleeding
1.3. Kidney dialysis
1.4. Liver disease
1.5. Crohn's disease
1.6. Celiac disease
1.7. Diet intake or absorption of folate is inadequate
1.8. Medicationns
1.9. Pregnant women, breastfeeding mothers
2. Diagnostic tests
2.1. Blood test - measured as methyltetrahydrofolate and elevation of the Homocysteine level
2.2. Serum folate levels < 3 ng/ml and a red blood cell (RBC) folate level < 140 ng/ml indicate folate deficienccy
2.3. Complete Blood Count
3. Treatments
3.1. Eat leafy green vegetables and fruits
3.2. Fortified food & multi-vitamin dietary supplements contain folate and other B vitamins
4. Immunity
4.1. Folate deficiency anemia could lead to reduced immune function. Alters the NK cytotoxicity and B lymphocyte. Folate deficiency in cultured phytohaemaglutinin-activated human T lymphocytes, is able to reduce T lymphocyte proliferation, to induce apoptosis and increase the CD4 to CD8 ratio dut to a marked reduction of CD8+ cell proliferation which lead to a lower resistance to infections.
5. Pathophysiologic etiology
5.1. Altered deoxyribonucliec acid (DNA) synthesis resulting from deficient nutrients. Macrocytic-normochromic anemia: large, abnormally shaped erthroccytes but normal hemoglobin concentrations, lake of folate for erythropoiesis. prematuree cell death
6. Common findings
6.1. Adults
6.1.1. Weakness
6.1.2. headaches
6.1.3. Irritability
6.1.4. Behavior disorders
6.1.5. Sore tongue
6.1.6. Weight loss
6.1.7. Loss of appettite
6.2. Pregnant Women, infants, and children
6.2.1. Neural tube defects
6.2.2. Low birth weight premature infants
6.2.3. Failure to thrive, slow growth ratte
6.2.4. Abnormally small head, developmental delay
6.2.5. Cerebellar ataxia
6.2.6. Seizures
6.2.7. Megaloblastic anemia