Megaloblastic anaemia: response to Amples A and B (folic acid, vitamin B12 (Cyanocobalamin), niacin and vitamin C)--a case report.

ABSTRACT

BACKGROUND: Megaloblastic anaemia is prevalent in our society and patients are diagnosed late. METHOD: Case Report of a patient with megaloblastic anaemia and discussion of relevant literature. RESULTS: A 50 year old Nigerian trader with recurrent chronic anaemia and repeated blood transfusions (Eight units in 10 days) was finally diagnosed to have megaloblastic anaemia. He was commenced on intramuscular, Ample A and Ample B (folic acid 0.7mg, vitamin B12 (Cyanocobalamin) 2500g, niacin 12mg and vitamin C 150mg) on alternate days (6 doses) then weekly as maintenance until haematocrit returned to normal. Response was dramatic; haemoglobin was 6.4g/dl before, 7.9g/dl after the second dose and 11.5g/dl after the 6th dose of the drug. The corrected retic was 2.0% before, 4.6% 72hrs after and 8.4% after the 6th dose. The MCV decreased from 105fl before to 79fl after the 6th dose of the drug. His packed cell volume has remained above 35% after completing the 6th dose and during maintenance therapy. CONCLUSION: The combination of Cyanocobalamin, folic acid, niacin, and vitamin C, in Amples A and B is complementary. Treatment with Amples A and B is effective and affordable in the management of megaloblastic anaemia.