Differential Diagnosis
Drug induced:
- Alcohol
- Antineoplastics
- Antithyroid drugs
- Antibiotics
- Hypoglycemic agents
- Azidothymidine
- Anticonvulsants (interfere with B-12, folate)
- Antineoplastics (interfere with B-12, folate)
- Antimalarial drugs
- Aspirin
- NSAIDs
- Steroids
Megaloblastic:
- B-12 deficiency (vegan, vegetarian, breast feed infants)
- Atrophic gastritis
- Partial gastrectomy
- Loss of gastric mucosa
- Zollinger-Ellison syndrome
- Blind-loop syndrome
- IF receptor deficiency
- Folate deficiency
Pernicious:
- B-12 deficiency
- Malabsorption
- Alcoholism
- Folic acid deficiency
- Chronic gastritis
Iron deficiency:
- Anemia of chronic diseases
- Sidroblastic anemia
- Thalassemia trait
- Lead poisoning
ANA positive:
- SLE
- Drugs:
- Phenitoin
- Ethosuximide
- Primidone
- Methyldopa
- Hydralazine
- Carbamazepine
- Penicillin
- Procainamide
- Thiazides
- Autoimmune hepatitis
- Rheumatoid arthritis
- Scleroderma
- Mixed connective tissue disease
- Necrotizing vasculitis
- Sjogren’s syndrome