Overview
Folate, also known as vitamin B9, is an important coenzyme in DNA and amino acid metabolism pathways.
Pathogenesis
Causes of Folate Deficiency
- Nutritional deficiency - poor intake, alcohol abuse
- Malabsorption - coeliac disease, inflammatory bowel disease, jejunal resection
- Increased requirement - pregnancy, malignancy
- Impaired metabolism - methotrexate, trimethoprim
Manifestations
Manifestations of Folate Deficiency
- Megaloblastic anaemia
- Neural tube defects (deficiency during pregnancy)
- Increased cardiovascular risk
- Dementia
Diagnosis
Investigations
- Reduced serum red cell folate levels
- Macrocytic, hyperchromic anaemia
- Hypersegmented neutrophils
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