Folate deficiency

Last updated: Tuesday, 03, August, 2010
CausesAppropriate Tests

FBC, blood film, (often pancytopenia; oval macrocytosis, neutrophil hypersegmentation), platelet count; folate - red cell; vitamin B12 assay, if indicated.

Bone marrow aspiration is only occasionally required for diagnosis and/or confirmation.

Review clinical findings to determine likely cause.

Dietary deficiency

Alcoholism

Extremes of age - especially premature infants.

Haemodialysis

Debilitating illness

Malabsorption especially

  • Coeliac disease
  • Jejunal resection

Jejunal resection

Drugs (may impair folate absrption), especially;

  • Anticonvulsants
  • Oral contraceptives

 

 

Low serum folate but adequate RBC folate.

Increased requirements

Pregnancy

Malignancy (desseminated)

Haemolysis

Impaired utilisation

Alcoholism

Drugs, especially;

  • Methotrexate
  • Trimethoprim
  • Salicylazosulphapyridine