Megaloblastic anaemia in Zimbabwe: spectrum of clinical and haematological manifestations.

An analysis of 100 cases (43 males and 57 females) with confirmed megaloblastic anaemia is presented. The age distribution showed two peaks with 18% in the third and fourth decades and 25% in the seventh decade. Anaemia of moderate to severe degree occurred in all patients and accounted for the commonest triad of symptoms at presentation viz: weakness (73%); breathlessness (40%) and headaches (33%). Macrocytosis or macroovalocytosis and neutrophil hyper-lobulation were found in all cases; MCV greater than 100fl in 84%; pancytopenia in 47%; and megaloblastic haematopoiesis found in all patients varied from moderate to gross in severity. Thus, the finding of macrocytic anaemia with a high MCV particularly in excess of 100fl, neutrophil hypersegmentation, and characteristic megaloblastic changes in the bone marrow should dictate further appropriate investigations to help in establishing the specific diagnosis if appropriate therapeutic intervention is to be ultimately instituted.