Masked phenytoin-induced megaloblastic anemia in beta-thalassemia minor.
We report the occurrence of megaloblastic hematopoiesis with peripheral microcytosis in a beta-thalassemic heterozygote who developed profound anemia secondary to folate deficiency. The folate deficiency was precipitated by prolonged therapy with diphenylhydantoin. In thalassemic heterozygotes who develop anemia, the possibility of a megaloblastic pathogenesis should be pursued even when the RBC indices maintain their microcytic-hypochromic expression.
D000328:Adult; D000748:Anemia, Macrocytic / Q000209:etiology*; D000749:Anemia, Megaloblastic / Q000209:etiology*; D005260:Female; D005494:Folic Acid Deficiency / Q000139:chemically induced; D006801:Humans; D010672:Phenytoin / Q000009:adverse effects*; D013789:Thalassemia / Q000150:complications*
D010672:Phenytoin