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Folates and Cobalamins (Paperback)
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Folates and Cobalamins (Paperback)
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It is usual to associate megaloblastic anemia with folate or
cobalamin deficien- cies. However, this notion, even if true in
most cases, is too restricted. Megalo- blastosis in blood may also
be observed in blood diseases without vitamin defi- ciency, and
also after treatment with certain antineoplastic agents; in these
con- ditions, the mechanisms vary with the etiology. On the other
hand, folate or cobalamin deficiency may induce various clinical or
biochemical disturbances without - as yet - macrocytic
megaloblastic anemia. That the biochemical basis of megaloblastosis
is the same in folate and cobal- amin deficiencies is due to the
close metabolic interrelationships between thse two vitamins.
However, the role of cobalamin deficiency in folate metabolism is
still a matter of debate. Morphological abnormalities such as
macrocytosis in peripheral blood and megablastosis in bone marrow,
long considered to be the best indices of vitamin deficiency, are
not always constant. Indeed, the improved diagnostic methods often
lead to an early diagnosis of deficiency before the appearance of
the usual hematological abnormalities.
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