Last updated: Monday, 20, December, 2010
FBC, blood film (often pancytopenia; oval macrocytes, hypersegmented neutrophils). Serum vitamin B12 and RBC folate assays.
Elevated bilirubin and LD are due to haemolysis, including intramedullary haemolysis.
Bone marrow aspiration rarely required to confirm diagnosis.
Review clinical findings to guide investigation of cause.See also Anaemia
Inhibition of folate metabolism, especially
In susceptible individuals.
Inactivation of vitamin B12
Prolonged exposure, especially anaesthetists.
Inhibition of pyrimidine, purine synthesis, DNA assembly, especially
Inborn errors of metabolism
Rare - consult pathologist.