Nutritional megaloblastic anemia during childhood: Demographical, clinical and laboratory features of 134 patients from southeastern part of Turkey

summary Background & aims: Nutritional megaloblastic anemia is a common disease among young children in the developing and underdeveloped countries. The aim of this study was to examine the laboratory and clinical characteristics of megaloblastic anemia patients diagnosed at Pediatric Hematology Unit of Dicle University Hospital. Methods: Between March 2002 and February 2007, a total of 665 patients with anemia were examined and 134 (20%) cases were diagnosed with nutritional megaloblastic anemia. Medical records of 134 patients (74 male, 55.2%; 60 female, 44.8%) were evaluated retrospectively. Results: Of these, 126 (94%) were from low socio-economical backgrounds and 110 (82%) were younger than 2 years of age. The most common reasons for admission were paleness (48%), high fever (29%), diarrhea (23%), weakness (21%), irritability (21%), failure to thrive (18%), vomiting (16%), and neurological findings such as tremor (16%) and inability to walk (2%). The diagnosis was based on physical examination, peripheral blood smear, complete blood count, vitamin B12, and folate levels in all patients. Bone marrow aspiration was made only in 41 patients. This sample population contained a high proportion of young children from lower socio-economical backgrounds (82% <2 y and 94% from lower socioeconomical background). Conclusions: The diagnosis of nutritional megaloblastic anemia should always be borne in mind in young children presenting with anemia in the developing and underdeveloped countries.