most often associated with iron deficiency anemia necessary for closure of neural tube during early fetal development minimum daily req...
- most often associated with iron deficiency anemia
- necessary for closure of neural tube during early fetal development
- minimum daily requirement is 0.5 mg
- takes approximately 18 weeks of folate deficient diet to produce anemia
- leafy green vegetables good source of dietary folate
Etiology
- malnutrition
- malabsorption (e.g. sprue) c
- hronic hemolytic anemia (e.g. SCD)
- multiple gestation medications (i.e. phenytoin, trimethoprim-sulfamethoxazole, oral contraceptives)
- maternal: smaller blood volume, nausea, vomiting, anorexia
- fetal: NTD in T1, low birth weight, prematurity
Diagnosis
- suspect if iron deficiency anemia fails to respond to treatment
- CBC, blood film, red blood cell folate levels
- megaloblastic anemia and hypersegmented neutrophils on smear
- glossitis and skin roughness
- NO neurologic symptoms (unlike B12 deficiency)
- elevated serum iron and transferrin saturation
Treatment
- 1 mg folic acid PO daily
- 4 mg folic acid per day with past history of neural tube defect
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