Folic acid deficiency - Altmeyers Encyclopedia

Synonym(s)

vitamin B9 deficiency

Definition
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Folic acid deficiency describes the reduction of the essential vitamin folic acid (also vitamin B9) below the physiologically required levels. Folic acid plays an important role in DNA synthesis. Folic acid deficiency leads to megaloblastic anaemia and gastrointestinal disorders.

Etiopathogenesis
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Malnutrition (alcoholics, old people with a one-sided diet)
Increased need (pregnancy, haemolysis)
Malabsorption syndromes (absorption in the jejunum disturbed)
Medication: Folic acid antagonists ( methotrexate), purine and pyrimidine antagonists, diphenylhydantoin.

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Clinic
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Symptoms of megaloblastic anemia: paleness, discrete jaundice, fatigue, reduced performance. Trophic disorders of the mucosa, especially of the gastrointestinal tract. S.u. Glossitis Möller-Hunter, Perlèche.

Laboratory
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Megalocytes in peripheral blood smear, MCV > 95 fl, MCH > 34 pg, often leukopenia and thrombopenia, reduction of folic acid, iron, LDH and indirect bilirubin.

Therapy
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If necessary, treatment of the underlying disease, oral folic acid substitution (see folinic acid).

Literature
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Weatherhead SC et al (2007) An open-label, dose-ranging study of methotrexate for moderate-to-severe adult atopic eczema. Br J Dermatol. 2007 156: 346-351