Folate deficiency in the classic form presents as anaemia with decreased reticulocyte numbers and oval macrocytosis (mean corpuscular volume [MCV] >100 femtolitres). Severe folate deficiency can present as pancytopenia (anaemia, neutropenia, and thrombocytopenia). Neurological signs and symptoms are not typically seen in patients with folate deficiency. Alternative explanations, such as co-existing vitamin B12 (cobalamin) deficiency, thiamine deficiency, or alcoholism, should be considered in cases of macrocytic anaemia with neurological signs and symptoms.

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