Last reviewed:December 2019
Last updated:January  2020

Summary

Definition

History and exam

Other diagnostic factors

  • prolonged diarrhea
  • headache
  • loss of appetite and weight loss
  • fatigue
  • shortness of breath
  • dizziness
  • pallor
  • tachycardia
  • tachypnea
  • heart murmur
  • signs of heart failure
  • signs of chronic alcohol abuse
  • signs of hemolytic anemia
  • signs of exfoliative dermatitis
  • painful swallowing
  • petechiae
  • glossitis
  • angular stomatitis
  • neurologic deficits in children

Risk factors

  • low dietary folate intake
  • age >65 years
  • alcoholism
  • pregnant or lactating
  • prematurity
  • intestinal malabsorptive disorders
  • use of trimethoprim, methotrexate, sulfasalazine, pyrimethamine, or anticonvulsants (e.g., phenytoin, phenobarbital)
  • infantile intake of goats' milk
  • congenital defects in folate absorption and metabolism
  • states of increased cell turnover
  • intake of special diet
  • chronic dialysis

Diagnostic investigations

Treatment algorithm

Contributors

Professor of Medicine, Emeritus (Hematology/Oncology)

Vanderbilt University Medical Center

Nashville

TN

Disclosures

MK declares that he has no competing interests.

Assistant Professor of Pathology, Microbiology, and Immunology

Assistant Professor of Pediatrics (Pediatric Hematology-Oncology)

Vanderbilt University Medical Center

Nashville

TN

Disclosures

APW declares that she has no competing interests.

Research Professor of Medicine (Nephrology)

Vanderbilt University Medical Center

Nashville

TN

Disclosures

MS declares that he has no competing interests.

Dr Mark Koury, Dr Allison Wheeler, and Dr Mohammed Sika would like to gratefully acknowledge Dr Lakshmi V. Srivaths and Donald Mahoney Jr., previous contributors to this topic. LVS and DM declare that they have no competing interests.

Peer reviewersVIEW ALL

Professor and Chair

Department of Pathology and Laboratory Medicine

University of California Davis School of Medicine

Sacramento

CA

Disclosures

RG is the author of reference(s) cited in this topic.

Emeritus Professor and Consultant Haematologist

Dorevitch Pathology

Heidelberg

Victoria

Australia

Disclosures

JM declares that he has no competing interests.

Use of this content is subject to our disclaimer