[Management, prevention and control of megaloblastic anemia, secondary to folic acid deficiency].
Folic acid deficiency is the second most common cause of anemia in our environment, after anemia secondary to iron deficiency. Folates are essential components of human and animal diet. Folic acid is mainly in poliglutamate form, and it is hydrolyzed in the proximal jejunum. It is important to identify adequately the exact vitamin deficiency that causes megaloblastic anemia, because vitamin B12 administration in folate deficiency may correct partially megaloblastic alterations, but administration of folic acid in cobalamin deficient patients improves haematological parameters but deteriorates the neurological syndrome. Main causes of anemia secondary to folate deficiency are inadequate dietetic administration, increased requirements, impaired absorption and pharmacologic interactions. Folates are altered by light, high temperature and by water affinity, which facilitates its elimination by washing or cooking.
Servicio de Hematología y Hemoterapia, Hospital Universitario La Paz, Madrid, España. depazraquel@terra.es
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de Paz
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Hernández-Navarro
D000749:Anemia, Megaloblastic / Q000209:etiology* / Q000517:prevention & control / Q000628:therapy*; D005494:Folic Acid Deficiency / Q000150:complications*; D006801:Humans; D017410:Practice Guidelines as Topic