FOLIC-ACID-DEFICIENCY ANEMIA

type of anemia that is a result of a deficient intake of folic acid. This B vitamin is needed for the formation of heme, the pigmented, iron-containing portion of the hemoglobin in red blood cells. A deficient intake of folic acid impairs the maturation of young red blood cells, which results in anemia. The disease is characterized by deficiency of red blood cells (anemia) and often white cells (leukopenia) and platelets (thrombocytopenia) in the circulation, ineffective blood formation in the bone marrow, and progressive gastrointestinal problems. Folic-acid deficiency develops over a period of several months and may result from a diet that is low or lacking in foods containing folic acid. The deficiency may also be caused by intestinal malabsorption, cirrhosis of the liver, or anticonvulsant-drug therapy. It may also occur in the last three months of pregnancy and in persons with severe hemolytic anemia (dissolution of red blood cells by hemolysin). In infants it can result from a diet of unsupplemented goat's milk or dried milk. The symptoms and signs of folic-acid deficiency include a blood picture indistinguishable from that of pernicious anemia, with megaloblastic bone marrow, macrocytes in the circulation, and marked gastrointestinal problems, such as sore tongue, fissures at corners of the mouth, diarrhea, inflammation of the pharynx or esophagus or both, and ulceration of the stomach and intestines. Treatment is specific: the administration of folic acid by mouth produces quick improvement in all symptoms; an adequate diet results in cure in cases due to simple malnutrition.