Clinical case of megaloblastic anemia in a pediatric patient

Abstract

Megaloblastic anemias include B₁₂ deficiency and folate deficiency anemia. The development of megaloblastic anemia caused by a combined deficiency of vitamin B₁₂ and folic acid is a fairly rare condition. This article presents our own clinical observation of a case of megaloblastic anemia in an 11-year-old boy resulting from a combined deficiency of vitamin B₁₂ and folic acid. A special feature of this clinical case is the presence of several comorbid conditions in a child with B₁₂-folate deficiency anemia (pneumonia, Down syndrome, Epstein — Barr virus infection). We believe that the cause for the development of vitamin B₁₂ and folate deficiency in this patient was the recurrent intestinal infections, which led to the development of a malabsorption syn- drome. The megaloblastic anemia was diagnosed during the ex- amination of the child for pneumonia, for which it served as an underlying condition. Our timely initiation of folic acid and cyano- cobalamin therapy ensured considerable clinical improvement of the megaloblastic anemia and contributed to an uncomplicated course of pneumonia in the patient.