Folate deficiency laboratory findings
|
Folate deficiency Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Folate deficiency laboratory findings On the Web |
|
American Roentgen Ray Society Images of Folate deficiency laboratory findings |
|
Risk calculators and risk factors for Folate deficiency laboratory findings |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Please help WikiDoc by adding more content here. It's easy! Click here to learn about editing.
Overview
Laboratory tests used to diagnose Folate deficiency include complete blood count, peripheral smear, serum LDH level, serum indirect biluribin level, serum folate level, RBC folate level, plasma or serum homocysteine level.
Laboratory Findings
First line investigations include the following:
- Complete blood count:
- Decreased hemoglobin and hematocrit levels
- Increased mean corpuscular volume (MCV >95 fl often >110) and mean corpuscular hemoglobin (MCH)
- Low corrected reticulocyte count which indicates decreased production by the bone marrow.
- The platelet count may be reduced.
- Examination of peripheral blood smear :
- Neutrophil granulocytes may show multisegmented nuclei ("senile neutrophil"), due to decreased production and a compensatory prolonged lifespan for circulating neutrophils.
- Anisocytosis (increased variation in RBC size) and poikilocytosis (abnormally shaped RBCs).
- Macrocytes (larger than normal RBCs) are present.
| Reference Range | |
| Folic Acid in Serum/Plasma Deficiency | 3.6-15 mg/dl |
| Adequate Folic Acid Supply | > 4 ug/l |
| Erythrocyte Folic Acid | 120-800 ug/l |
Blood chemistries will also show:
- Elevated serum LDH and indirect biluribin level
- Low serum folate level, usually <2.5ng/ml, suggestive of acute changes in folate level
- Low RBC folate level, reflect long term folate status
- Increased homocysteine in folate deficency
Some investigations done to rule out the other causes of megaloblastic anemia include:
- serum vitamin B12
- serum iron panel
- plasma or serum methylmalonic acid