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Megaloblastic anemia, stemming from vitamin B12 or folate deficiencies, poses diagnostic challenges due to its diverse clinical presentation. We report a case of a 25-year-old female college student presenting with symptoms indicative of megaloblastic anemia, attributed to her recent adoption of a strict vegetarian and vegan diet. Clinical manifestations included dizziness, palpitations, blurred vision, vertigo, headaches, burning sensations, excessive sweating, mouth ulcers, and unintentional weight loss. Physical examination revealed pale palpebral conjunctiva and sweating on the palms and soles. Laboratory findings confirmed megaloblastic anemia secondary to vitamin B12 deficiency, with elevated mean corpuscular volume (MCV), reticulocyte count, serum methylmalonic acid (MMA), and homocysteine levels. Treatment with intramuscular cyanocobalamin injections and oral vitamin B12 supplementation led to symptomatic improvement and normalization of hematological parameters. This case underscores the crucial role of dietary habits in hematological health. Vegetarian and vegan diets, devoid of animal products rich in vitamin B12, increase the risk of deficiency. Early recognition and management of such deficiencies are imperative to prevent long-term complications. A literature review corroborates the association between vegetarianism/veganism and megaloblastic anemia risk. Healthcare providers should vigilantly assess dietary histories, particularly in patients with hematological abnormalities. Further research is warranted to explore strategies for optimizing nutrient intake in individuals adhering to vegetarian or vegan diets, aiming to mitigate the risk of nutritional deficiencies and associated complications.
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http://dx.doi.org/10.7759/cureus.61550 | DOI Listing |
Indian Pediatr
August 2025
Pediatric Intensive Care Unit, Rio Children's Hospital, Madurai, Tamil Nadu, India.
Cureus
August 2025
Family Medicine, Florida Atlantic University Charles E. Schmidt College of Medicine, Boca Raton, USA.
Pellagra is a disease of niacin (vitamin B3) deficiency and is classically characterized by the triad of diarrhea, dermatitis, and dementia, and has the potential to cause death. Pellagra can be caused by either insufficient dietary intake or dysfunctional utilization of niacin. Because niacin can be found in nearly every food group (meat, dairy, vegetables, grains, etc.
View Article and Find Full Text PDFBlood Cells Mol Dis
November 2025
Lister Hospital, East and North Hertfordshire NHS Trust, United Kingdom. Electronic address:
Cureus
July 2025
Internal Medicine, Ascension Sacred Heart/Florida State University College of Medicine, Pensacola, USA.
Vitamin B12 (cobalamin) is a vital cofactor in DNA synthesis and hematopoiesis, and its deficiency can lead to a wide spectrum of clinical manifestations, ranging from asymptomatic macrocytosis to severe hematologic and neurologic complications. While megaloblastic anemia is the most common presentation, prolonged or profound deficiency can result in pancytopenia due to ineffective hematopoiesis and intramedullary cell death. This can mimic more serious bone marrow disorders, including leukemia or aplastic anemia, potentially leading to invasive diagnostic procedures if the deficiency is not promptly recognized.
View Article and Find Full Text PDFInt J Mol Sci
July 2025
Department of Pharmaceutical Chemistry and Biomaterials, Faculty of Pharmacy, Medical University of Warsaw, Banacha 1 Str., 02-091 Warsaw, Poland.
Cobalt is an essential trace element involved in key biological processes. It serves most notably as a component of vitamin B (cobalamin) and a regulator of erythropoiesis. While cobalt deficiency can lead to disorders such as megaloblastic anemia, excess cobalt poses toxicological risks to the thyroid, cardiovascular, and hematopoietic systems.
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