最近审阅: 26 十月 2020
最近更新: 10 一月 2020

小结

定义

病史和体格检查

其他诊断因素

  • 长期腹泻
  • 头痛
  • 食欲不振和体重下降
  • 疲劳
  • 呼吸短促
  • 头晕
  • 苍白
  • 心动过速
  • 呼吸急促
  • 心脏杂音
  • 心力衰竭的征象
  • 长期酗酒的体征
  • 溶血性贫血的体征
  • 剥脱性皮炎的体征
  • 吞咽疼痛
  • 瘀斑
  • 舌炎
  • 口角炎
  • 儿童的神经功能缺损

危险因素

  • 膳食中叶酸摄入低
  • 年龄> 65 岁
  • 酗酒
  • 妊娠或哺乳
  • 早产
  • 肠道吸收不良性疾病
  • 使用甲氧苄啶、甲氨蝶呤、柳氮磺胺吡啶、乙胺嘧啶或抗惊厥药(例如苯妥英、苯巴比妥)
  • 摄入山羊奶的婴儿
  • 先天性的叶酸吸收和代谢缺陷
  • 细胞更新增加的状态
  • 摄入特殊膳食
  • 长期透析

诊断性检查

首要检查

  • 外周血涂片
  • 全血细胞计数 (FBC)
  • 网织红细胞计数
更多 首要检查

需考虑的检查

  • 血清叶酸
  • 红细胞内叶酸
  • 血清维生素 B12
  • 血清乳酸脱氢酶
  • 血清非结合胆红素
  • 血清铁检查
  • 血浆或血清甲基丙二酸
  • 血浆同型半胱氨酸
  • 骨髓穿刺/活检
更多 需考虑的检查

治疗流程

撰稿人

Professor of Medicine, Emeritus (Hematology/Oncology)

Vanderbilt University Medical Center

Nashville

TN

利益声明

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

利益声明

APW declares that she has no competing interests.

Research Professor of Medicine (Nephrology)

Vanderbilt University Medical Center

Nashville

TN

利益声明

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.

同行评议者展开全部内容

Professor and Chair

Department of Pathology and Laboratory Medicine

University of California Davis School of Medicine

Sacramento

CA

利益声明

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

Emeritus Professor and Consultant Haematologist

Dorevitch Pathology

Heidelberg

Victoria

Australia

利益声明

JM declares that he has no competing interests.

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