Megaloblastic pernicious anemia

What causes megaloblastic, or pernicious, anemia?

In children, megaloblastic anemia most often occurs as result of a dietary deficiency of folic acid. Folic acid is a "B" vitamin required for the production of normal red blood cells. Folic acid is present in foods such as green vegetables, liver, and yeast. It is also produced synthetically and added to many food items. Other causes of megaloblastic anemia include the following:

• Digestive diseases—Certain diseases of the lower digestive tract, including celiac disease, chronic infectious enteritis, and enteroenteric fistulas, can lead to megaloblastic anemia.
• Malabsorption-Inherited congenital folate malabsorption, a genetic problem in which infants cannot absorb folic acid in their intestines, can lead to megaloblastic anemia. This requires early intensive treatment to prevent long-term problems, such as mental retardation.
• Medication-induced folic acid deficiency—Certain medications, specifically ones that prevent seizures, such as phenytoin, primidone, and phenobarbital, can impair the absorption of folic acid. The deficiency can usually be treated with a dietary supplement.

What are the symptoms of megaloblastic (pernicious) anemia?

Each child may experience symptoms differently, but common symptoms include:

• pale skin, lips and hands
• decreased appetite
• irritability
• lack of energy or fatigue
• diarrhea
• difficulty walking
• numbness or tingling in hands and feet
• smooth and tender tongue
• weak muscles