Anemia defisiensi asam folat
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INTRODUCTION Anemia is a widespread public health problem associated with an increased risk of morbidity and mortality, especially in pregnant women, women of child-bearing, and young children. Anemia can be defined as an inadequate condition of the mass of erythrocyte or hemoglobin in vascular to supply oxygen for tissues. Anemia is also a condition when hemoglobin concentration below the normal ranges more than two standard deviations for age and gender. 1 Generally, clinical criteria for anemia that used at hospital or private practice in Indonesia are: (1) hemoglobin <10 g/dl; (2) hematocrit <30%; (3) erythrocyte < 2.8 million/mm 3 . 2 According to WHO, 1.62 billion people are anemia (95% CI: 1.50–1.74 billion), which corresponds to 24.8% of the population (95% CI: 22.9–26.7%). 3 Based on Survei Kesehatan Rumah Tangga on 2004, prevalence of anemia in Indonesia can be described as: under five years 40,5%, pregnant woman 50,5%, post-partum woman 45,1%, girl teenager 10-18yr 57,1%, and 19- 45yr 39,5%. The data figure that woman is at high risk to get anemia. 4 The etiology of anemia is diverse. Among the numerous factors, both nutritional (such as vitamin and mineral deficiencies) and non-nutritional (such as infection and hemoglobinopathies) contribute to the onset of anemia. Although nutritional anemias are predominantly caused by iron deficiency in both developed and less developed countries, B4 | Folate Deficiency Anemia 1
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Folic acid (pteroylglutamic acid) is a water soluble member of the B-complex family of vitamins. Folic acid has function in DNA synthesize. Deficiency in folic acid lead to disturbance of maturing DNA, make the cell become megaloblast. This megaloblast has short life span because intramedullary hemolysis. The etiology of folate deficiency anemia maybe come from several factor, there are impaired absorption, increase folate requirement, alcohol, and other cause such as medications, sulfa drugs, anticonvulsant, and etc. To diagnose the anemia, comprehensive history, physical examination followed by appropriate laboratories examination such as CBC, peripheral blood smear, bone marrow aspiration, RBC folate, and MMA should be performed. To treat the patient, folic acid per oral should be given. Otherwise if there is no preparation of folate per oral, or no respond from patient to medication, dilution or per parenteral should be performed. The overarching and long-term strategy recommended for the control of folate deficiency is the consumption of a diet that meets the recommended intakes of these vitamins. However, in populations where it is unlikely that diet will provide recommended intakes of these nutrients, strategies such as supplementation and fortification should be considered. The duration of therapy depends on the basis of deficiency states. Patients with a continuously increased requirement (such as hemolytic anemia) or those with malabsorption or chronic malnutrition should continue to receive oral folic acid indefinitely.
Transcript of Anemia defisiensi asam folat
INTRODUCTION
Anemia is a widespread public health problem associated with an increased risk of morbidity and mortality, especially in pregnant women, women of child-bearing, and young children. Anemia can be defined as an inadequate condition of the mass of erythrocyte or hemoglobin in vascular to supply oxygen for tissues. Anemia is also a condition when hemoglobin concentration below the normal ranges more than two standard deviations for age and gender.1 Generally, clinical criteria for anemia that used at hospital or private practice in Indonesia are: (1) hemoglobin
