title: Megaloblastic anemia with hypotension and transient delirium as the primary symptoms: report of a case.
abstract: The present study describes a case of an elderly patient that was hospitalized secondary to hypotension and delirium. Physical examination at admission revealed bilateral positive Babinski's sign. Laboratory examination revealed severe anemia. Bone marrow examination showed megaloblastic changes of the granulocyte and erythroid series, as well as other dyshaematopoiesis. The conditions of the patient rapidly improved after vitamin B12 treatments. Because the clinical manifestations of megaloblastic anemia are complex, this disease is often misdiagnosed in the geriatric population. Bone marrow examinations can aid in the diagnosis of anemia, but the results from these tests cannot always differentiate the type of anemia. Clinical management of the disorder is reliant upon proper classification of the type of anemia. The prognosis of megaloblastic anemia is typically good and a simple regimen of folic acid and/or vitamin B12 is effective.
authors.affiliation: Department of Geriatrics, The First Affiliated Hospital, School of Medicine, Zhejiang University Hangzhou, China.
authors.forename: Qin
authors.initials: Q
authors.lastname: Zhang
authors.affiliation: Department of Geriatrics, The First Affiliated Hospital, School of Medicine, Zhejiang University Hangzhou, China.
authors.forename: Xue-Ying
authors.initials: XY
authors.lastname: Lv
authors.affiliation: Department of Geriatrics, The First Affiliated Hospital, School of Medicine, Zhejiang University Hangzhou, China.
authors.forename: Yun-Mei
authors.initials: YM
authors.lastname: Yang
keywords: Megaloblastic anemia; delirium; elderly; hypotension; vitamin B12