Purpose: The reticulocyte count is the exact method in the evaulation of therapeutic response of megaloblastic anemia to the vitamin B-12 treatment. In cases of vitamin B-12 deficiency presented with a combination of anemia/thrombocytopenia or pancytopenia, we aimed to study the therapeutic response of thrombocytes (which have shorter life span than reticulocytes) in relation to reticulocytes.
Material and methods: From 102 patients of megaloblastic anemia due to vitamin B-12 deficiency, who where followed up between January 2005 and August 2009 in our medical department, forty-six patients (who had no blood transfusion) with a combination of anemia/thrombocytopenia or pancytopenia were "ed for this study. Pre and post (6th day) of vitamin B-12 treatment, corrected reticulocyte and platelet levels were compared using independent t-test, the paired t-test, and Pearson correlation test (NCSS 2007 software program).
Results: At 6th day of vitamin B-12 treatment (in compare to day 0), there was a significant increase in both platelet counts and corrected reticulocyte rates (63,98±30,28x 103/mm3 versus 162,63±85,35x 103/mm3 , and 0.57±0.42% versus 4,61±2,66%, p=0,0001, and 0,001, respectively). Also there was a positive correlation between the changes in the corrected reticulocyte rate and the changes in platelet counts (r=0,480, and P=0,001)
Conclusions: Increase in platelet counts can be used (if fascilities for reticulocyte count is not available) as an indicator of early bone marrow response to vitamin B-12 replacement therapy in vitamin B-12 deficiency cases presented with a combination of anemia/thrombocytopenia or pancytopenia. If there is no such post-treatment increase in platelet counts, myelodysplastic syndrome should be excluded by bone marrow aspiration and/or biopsy.
Key words: Megaloblastic anemia, reticulocyte crisis, thrombocyte
|
