Page 82 - Essential Haematology
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(a)                                        (b)





























                    (c)                                        (d)


                              Figure 5.12   Megaloblastic changes in the bone marrow in a patient with severe megaloblastic anaemia.
                      (a – c)  Erythroblasts showing fi ne, open stippled (primitive) appearance of the nuclear chromatin even in late
                    cells (pale cytoplasm with some haemoglobin formation).  (d)  Abnormal giant metamyelocytes and band forms.
                         Table 5.7   Laboratory tests for vitamin B  12  and folate defi ciency.

                                                                                      Result in


                           Test          Normal values  *                  Vitamin B  12   defi ciency   Folate defi ciency


                         Serum vitamin B  12        160 – 925   ng/L     120 – 680   pmol/L     Low     Normal or
                                                                                      borderline
                         Serum folate        3.0 – 15.0   μ g/L         4 – 30   nmol/L     Normal or raised     Low

                         Red cell folate         160 – 640   μ g/L         360 – 1460   nmol/L   Normal or low     Low


                             *   Normal values differ slightly with different commercial kits.
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