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Megaloblastic anemia

#Megaloblastic_Anemias
the  hematopoietic  precursors  show  nuclear-cytoplasmic  asynchrony
Why? 
B12 and folic acid essential  factors  for  the  synthesis  of thymidylate, require for  DNA  replication (thymine)
So in B12 or folate deficiency  causes  abnormalities  in  rapidly  dividing cells
But the cytoplasm doesn't affected because it doesn't need DNA replication
It need RNA and RNA need uracil dosent  need thymine
So proteins ( hemoglobin) synthesis is normal 
However HB concentration is decrease 
Why?  🤔
Because in BM macrophage engulf some of megaloblastic cells
And some of megaloblastic cells undergo apoptosis 
So just 10% from it became macrocyte and flow to circulation and these cells macrocyte so hemolytic easily
Macrocyte ↑MCV
↓Hb concentration
↓PCV 
↓RBC Count
MCH = normal (normochromic)

Megaloblastic anemia

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