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KMID : 0378120030300020171
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Chungnam Medical Journal
2003 Volume.30 No. 2 p.171 ~ p.177
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Clinical Analysis of Megaloblastic Anemias
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Kwak Seung-Keon
Chun Jae-min
Park Nam-Sook
Park Sang-Eun
Park Su-Jin
Yun Hwan-Jung
Kim Sam-Yong
Jo Deog-Yeon
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Abstract
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Megaloblastic anemias are disorders caused by impaired DNA synthesis and chara-cterized by the presence of megaloblastic cells. Clinical data on these disorders in Korea are limited. The aim of this study was to analyze clinical characteristics of megaloblastic anemias caused by vitamin B12 deficiency.
We identified 40 cases who were diagnosed as megaloblastic anemia from January 1993 to December 2002 in a retrospective study on the basis of chart review. We investigated the annual distribution of diagnosed patients, clinical manifestations and response to treatment.
19 cases were complicated with a previous total gastrectomy(gastrectomy group) and 21 cases had no history of surgical operation(non-gastrectomy group).
The most common presenting complaint was generalized weakness. The median age at diagnosis was 7(range: 38-79) years in non-gastrectomy group. The mean pos-toperative duration was 7(range: 4-25)years in group of total gastrectomy and mean level of serum vitamin B12 was lower than 100 pg/mL in both group. Peripheral blood revealed thrombocy-topenia, macrocytic anemia and hypersegmented neutrophil in all cases. After treatment of pareliteral vitamin B12, Their clinical symptoms and hematologic findings improved except two patients who had bone marrow with lower cellularity.
Cobalamin replacement after total gastrectomy is still missing. Diagnoses are made too late in a population of patients, resulting in irreversible neurological sequale, and we suggest that Pernicious anemia seems not to be very rare in Korea.
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KEYWORD
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Vitamin B12 deficiency anemia, Hypersegmented neutrophil, Cobalamin
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