Haematology
B12 / Folate Deficiency
BSH 2014 — diagnosis, distinguish pernicious anaemia, urgent treatment if neuro features, B12 replacement schedule, dietary advice.
Source: BSH 2014; NICE CKS
Used in: Anaemia
Step 1 of ~6
info
Recognise + Confirm
Macrocytic anaemia (MCV ↑) with hypersegmented neutrophils on film. Symptoms: fatigue, glossitis, jaundice, peripheral neuropathy, subacute combined degeneration of cord (B12 — proprioception loss, ataxia, spasticity), cognitive change, mood. Bloods: serum B12, folate (red cell folate more reliable in acute starvation/pregnancy), homocysteine, methylmalonic acid (sensitive in early B12 deficiency), intrinsic factor antibody (positive 50%, highly specific for pernicious anaemia), parietal cell antibody, FBC + blood film. NEVER give folate alone in B12 deficiency — precipitates SACD.
Related
Curated clinical cross-links plus same-class fallbacks.
Drugs
- Thiamine (IV/IM — Pabrinex) · Vitamin B1 (Thiamine) — deficiency treatment / Wernicke's encephalopathy prevention
- Ferric Carboxymaltose (IV Iron — Pregnancy) · IV Iron Preparation — Iron Deficiency Anaemia in Pregnancy
- Iron Supplementation (Paediatric) · Iron Supplement — Iron Deficiency Anaemia in Children
- Methylphenidate · CNS Stimulant — Schedule 2 Controlled Drug (ADHD Treatment)
- Dextrose 10% IV · IV glucose solution (hypoglycaemia treatment)
- Glucose · Carbohydrate / hypoglycaemia treatment
Pathways
- Major Haemorrhage / Massive Transfusion · BCSH; RCOA; RCEM; RCS — BCSH Guidelines
- Anaemia Investigation · BSH / NICE
- Splenomegaly Workup · BSH; BMJ Best Practice
- Deep Vein Thrombosis Diagnosis and Treatment · NICE CG144 / NICE NG158
- Sickle Cell Crisis · BSH 2021 / BCSH
- Neutropenic Sepsis · NICE CG151 2012 / ESMO
Decision support only. Always apply local guidelines and clinical judgement.