John Olaniyi

By Olaniyi John Ayodele

Megaloblastic anemia is a multisystem disorder, which can easily be diagnosed with high index of suspicion and by correct application of its pathogenetic mechanisms. Any factor inhibiting deoxyribonucleic acid (DNA) synthesis, drugs (medications), infections like human immunodeficiency virus (HIV) and gas like nitrous oxide will cause megaloblastosis. However, poor diet, problems with absorption, transportation and metabolism of the vitamins, as well as factors that increase demand and ultimately exhaust the store of the vitamins like chronic hemolytic states, pregnancy, malignancies happen to be the commonest causes of megaloblastic anemia. A complete blood count, blood and marrow films review reflect the typical pathognomonic cytologic appearance of megaloblastic anemia. Logically selected biochemical tests help in establishing diagnosis through determination of serum levels of both folate and cobalamin and assessment of the metabolites, which are considered to be more sensitive and specific. Also, full endoscopic studies are required to confirm the presence of disorders of gastrointestinal tract responsible for impaired absorption. Clinical features are subtle and widely varied. It is highly amenable to therapy once the primary cause is established and managed. Appropriate replacement therapy of deficient nutrient, cobalamin or folate or both, easily corrects anemia. Pernicious anemia often requires lifelong therapy with parenteral cobalamin.

Part of the book: Current Topics in Anemia

By John Ayodele Olaniyi

Blood transfusion reaction/adverse transfusion reactions could be fatal/severe or mild, immediate or delayed, immunological or nonimmunological, and infectious or noninfectious, and attention is paid particularly to the incidence, possible causes and pathophysiology, clinical features, and management of each type with the aim of improving awareness and raising consciousness towards improving blood safety and judicious use of blood so as to forestall these blood transfusion reactions as much as possible. This chapter serves as a synopsis to adverse blood reactions, which are very common but apparently more often under-recognized and/or under-reported particularly in developing countries. This should sharpen the consciousness of all health practitioners involved in blood transfusion services towards taking measures at preventing transfusion reactions right from donor selection up to the infusion of blood into the recipients.

Part of the book: Blood Groups