- This disease is also caused by inadequate secretion of IF (intrinsic factor) by the parietal cells in the stomach — due to atrophy of the gastric mucosa or autoimmune destruction of the parietal cells. It is found most often in older individuals, particularly in those of northern European descent or in African Americans. It is less common in southern Europeans and Asians.
- Imurslund-Grasbeck syndrome is another documented cause for megaloblastic anemia. It is an autosomal recessive disorder characterized by intestinal vitamin B12 malabsorption and proteinuria.
- Poverty and malnutrition continues to cause cobalamin deficiency and leads to megaloblastic anemia.
- Weakness, especially in the arms and legs.
- Sore tongue.
- Nausea, appetite loss, and weight loss.
- Numbness or tingling in the hands and feet.
- Difficulty maintaining proper balance.
- Pale lips, tongue, and gums.
- Yellow eyes and skin.
- Bleeding gums.
- Shortness of breath.
- Depression, confusion, poor memory, and dementia.
- Ringing in the ears (tinnitus).
- Medication-induced macrocytosis.
- Liver disease-associated macrocytosis.
- Infiltrative disorders of the bone marrow.
- Nitrous oxide abuse.
- Splenectomy-induced macrocytosis.
- Test for methylmalonic acid in the serum as an indicator of vitamin B12 deficiency.
- Test for homocysteine to check folate levels.
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