Approach

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.

BMJ Best Practice is an evidence-based point of care tool for healthcare practitioners.

To continue reading and access all of BMJ Best Practice's pages you'll need to log in or start a free trial.

You can access through your institution if your hospital, university, trust or other institution provides access to BMJ Best Practice through either OpenAthens or Shibboleth.

Use of this content is subject to our disclaimer