Characteristics of Patients with Megaloblastic Anemia: A Retrospective Analysis – A Pediatric Center Experience

INTRODUCTION: This study aimed to evaluate the clinical and hematological characteristics of 39 pediatric cases diagnosed with megaloblastic anemia who were investigated and treated at the Pediatric Hematology Clinic of Yüzüncü Yıl University Faculty of Medicine between 2020 and 2025.
METHODS: A retrospective review of patient files was performed. Bone marrow aspiration findings, peripheral blood smear results, serum vitamin B12, and folic acid levels were analyzed and evaluated for the diagnosis of megaloblastic anemia.

RESULTS: Results: Of the patients, 19 (48.7%) were female and 20 (51.3%) male, with a mean age of 37.8 months (range: 11–168). The most common presenting symptoms were loss of appetite, pallor, and fatigue. Folic acid deficiency was detected in 4 patients, and vitamin B12 deficiency in 35 patients. The mean hemoglobin concentration was 6.1 g/dL, mean MCV 97.2 fL, mean white blood cell count 8104/mm³, and mean RDW 23.8. Proteinuria was observed in 3 patients (7.7%). All patients were treated with parenteral vitamin B12 and oral folic acid, resulting in significant improvement in laboratory parameters. Post-treatment, iron deficiency anemia developed in 2 patients (5.1%). In 14 patients (35.9%), the initial MCV value was below 90 fL.

DISCUSSION AND CONCLUSION: By presenting these cases, we aimed to emphasize that megaloblastic anemia may present without macrocytosis and highlight the importance of adequate nutrition in infants and pregnant women in our region.

Keywords: Megaloblastic anemia, hematological findings, clinical features, children