Young man with sickle cell anemia who presents with a macrocytic anemia with an abnormally low reticulocyte count, most likely due to folate deficiency
Key idea: Folate deficiency often related to (1) Chronic hemolysis (such as in sickle cell disease) (2) Poor dietary intake (such as in alcoholic) (3) Malabsorption (such as in gastric bypass or tropical sprue) and (4) medications (methotrexate, phenytoin, etc.)
submitted by โmedgirl11(20)
Sickle cell = hemolysis MCV > 100 Needs more folic acid supplementation to correct the anemia