What occurs in B12/Folate deficiency anemia?

• A. RBCs are abnormally large and non-functional
• B. An increase in white blood cells
• C. Excessive platelet production
• D. Decreased levels of hemoglobin

Answer: (A)

In B12 and folate deficiency anemia, the hallmark feature is the production of abnormally large red blood cells, known as macrocytes. This occurs because both vitamin B12 and folate are critical for proper DNA synthesis in the production of red blood cells. When there is a deficiency of either of these nutrients, the process of red blood cell maturation is impaired, leading to larger-than-normal cells that are not fully functional.

These macrocytic red blood cells often present in peripheral blood smears and can contribute to various clinical symptoms, including fatigue and weakness, due to their inability to efficiently transport oxygen despite their larger size. In extreme cases, this can result in ineffective erythropoiesis, where the production of red blood cells does not compensate for the anemia, further exacerbating the condition.

Other options, while they may present in different hematological conditions, do not specifically characterize B12 or folate deficiency anemia. For instance, while white blood cells might be affected in different anemias or during reactive processes, an increase is not a defining characteristic of these deficiencies. Similarly, excessive platelet production and decreased hemoglobin levels can occur in various other hematological disorders but do not represent the specific pathophysiology associated with B12