Hematology and Oncology Book

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Folate Deficiency

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  1. See Also
    1. Macrocytic Anemia
  2. Causes
    1. Inadequate folate intake
      1. Alcohol Abuse
      2. Elderly
      3. Vegan Diet
    2. Increased folate utilization
      1. Pregnancy
      2. Malignancy
    3. Medications
      1. See Medications Affecting Folate Metabolism
  3. Labs
    1. Complete Blood Count
      1. See Hemoglobin Cutoffs for Anemia
      2. See Hematocrit Cutoffs for Anemia
      3. Macrocytic Anemia (Mean Corpuscular Volume >100 um^3)
        1. MCV cutoff varies by age and per reference
    2. RBC Folate decreased
    3. Serum B12 normal
  4. Management
    1. Do not initiate folate until B12 Deficiency ruled-out
      1. Folate supplementation masks B12 Deficiency
      2. Neurologic B12 Deficiency sequelae will progress
    2. Folic Acid 1 mg PO qd for 3 weeks or until resolved
  5. References
    1. Brigden (1995) Postgrad Med 97(5):171

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