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Hammer, G. G., & McPhee, S. (2014). Pathophysiology of disease: An introduction to clinical medicine.(7th ed.) New York, NY: McGraw-Hill Education.Murphy, G., Dawsey, S. M., Engels, E. A., Ricker, W., Parsons, R., Etemadi, A., Lin, S., Abnet, C. C., & Freedman, N. D. (2015). Cancer risk after pernicious anemia in the US elderly population. Clinical Gastroenterology and Hepatology, 13(13), 2282-2289. doi:10.1016/j.cgh.2015.05.040Second ResponseHi Erin,Your post is interesting. Folate deficiency, vitamin B-12 deficiency, and anemia can have adverse effects on birth outcomes (Al-Khatib, Obeid, Sibai, Batal, Adra, and Hwalla (2006). Also, low vitamin B-12 reduces the formation of metabolically active folate. Furthermore, low folate status co-occurred with low vitamin B-12 status, underlining the importance of providing adequate vitamin B-12 and folic acid intake through approaches such as mandatory food fortification. Gupta, Copley, Keeney, and Chin-Yee (2016) emphasized that the approach to anemia is traditionally based on the Mean Cell Volume (MCV). Based on this approach anemia is subdivided into microcytic, normocytic and macrocytic causes. This approach may not accurately discern common causes of anemia in hospitalized patients. Clinicians need to be aware of the low sensitivity of the MCV as a screen. The sensitivity of MCV for iron-deficiency anemia (IDA) or vitamin B12 deficiency is improved with indices such as RDW. Huether and McCance (2017) noted that folate deficiency is rare in North America and should not be routinely ordered for assessment of nutritional anemia.References
Al-Khatib, L., Obeid, O., Sibai, A., Batal, M., Adra, N., & Hwalla, N. (2006). Folate deficiency is associated with nutritional anemia in Lebanese women of childbearing age. Public Health Nutrition,9(7), 921-927Gupta, M., Copley, K., Keeney, M., & Chin-Yee, I. (2016). Does cell size matter? Utilizing meancell volume in hospitalized patients as a screen to determine common causes of anemia including iron deficiency anemia, vitamin b12 and folate deficiency. Blood, 128(22), 2338Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology(6th ed.). St. Louis, MO: Mosby