Study to evaluate the role of serum LDH in the diagnosis of Megaloblastic anemia by treatment response at a tertiary care center in the northeastern part of India

Megaloblastic anemia and Myelodysplastic syndrome are generally considered mutually exclusive diagnosis and at times becomes difficult to diagnose on the first encounter even after performing bone marrow examination. Aim of this study is to evaluate the role of LDH in the diagnosis of Megaloblastic anemia by treatment response at a tertiary care center in the northeastern part of India. Patients with age more than 12 years, Hemoglobin of patients less than 10 gm/dl, MCV ≥ 100 fl, Reticulocyte count 100 fl) were included in the study. Median LDH values were higher in the patients who responded ( vitamin B12 deficient megaloblastic anemia ) as compared to non-responders. 93.5% of patients with megaloblastic anemia had Vitamin B12 deficiency, and in comparison, the folic acid deficiency was present among just 6.5 percent patients. Serum Vitamin B 12 and Folic acid level should not be used as a sole criterion for the diagnosis of Megaloblastic anemia and other parameters such as MCV, LDH, and characteristic blood picture, should all be taken into consideration before planning an appropriate treatment strategy.