Vitamin B12 deficiency with megaloblastic anemia: An experience at tertiary care hospital of sindh

Objective: to determine frequency of vitamin b12 deficiency in subjects with anemia and elevated mean corpuscular volume. study design: cross sectional study place and duration: department of medicine,liaquat university and isra university hospital hyderabad from january 2011 to august 2013. methodology: a sample of 113 subjects was selected according to inclusion and exclusion criteria. serum vitamin b12 deficiency was defined as per standard criteria. blood samples were analyzed on sysmex kx 21 hematology analyzer. continous variables were analyzed by anova and tukey-cramer test while categorical variables by chi-square test. the association between variables was analyzed by pearson's correlation. a p-value of ≤ 0.05 was taken statistically significant. results: of 113 subjects,37 (32.7%) were male and 76 (67.2%) female,mean±sd age was 34.48±6.71 years and 89.3% (n=101) were anemic. mean hemoglobin,hematocrit and rbc counts were found as 11.3 g/dl,33.1% and 3.0 million/μl respectively. of total 113 subjects,vitamin b12 deficiency was noted in 65 (57.5%); further subdivided as borderline and definitive deficiency in 19.4% and 37.9% respectively. mean corpuscular volume as high as 139 fl and vitamin b12 levels as low as <30pg/ml were found. pancytopenia was noted in 11 (9.7%) with severe vitamin b12 deficiency (<100pg/ml). significant negative correlation was found between vitamin b12 and mean corpuscular volume (r=-0.79,p=0.0001). peripheral blood film revealed anisocytosis,poikilocytosis,megaloblasts and hypersegmented neutrophils. conclusion: vitamin b12 deficiency is prevailing and is a major contributing factor of megaloblastic anemia.