Mech of Nonmegaloblastic macrocytic anemia?

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LuckiestOne

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In FA, it says that Liver disease, alcoholism, reticulocytosis, metabolic disorder, and drugs like 5FU, AZT, hydroxyurea can cause non megaloblastic macrocytic anemia.

I think those DNA synthesis inhibiting drugs as well as metabolic disorder such as orotic aciduria should probably cause megaloblastic anemia, no?

Also, I undersatnd that reticulocytosis would cause non-megaloblastic macrocytic anemia by just increasing the sheer number of reticulocytes.

But How does hypothyroidism, alcoholism and liver disease cause non-megaloblastic macrocytic anemia? Does anyone know the mech behind this?

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Very good questions. I've actually always wondered about the difference between megaloblastic and non-megaloblastic macrocytosis myself, as I believe I had heard/read that DNA synthesis isn't impaired in the latter, but that it is delayed/disrupted in the former.

However, that doesn't really explain much, so I agree that some clarification would be nice.

As far as orotic aciduria is concerned, that causes megaloblastic anaemia that isn't ameliorated by B9/B12.

Does anyone have any thoughts?
 
I know that alcohol is a mitochondrial poison, so I'm guessing that disruption of the mitochondria in such an energy-dependent process would lead to non-megaloblastic macrocytic anemia.

I would think that the liver disease would have something to do with the buildup of toxic substances that would inhibit division, but I'm not sure on this one.
 
Well I just reviewed that chapter in RR Path its due to excess cholesterol synthesis due to alcohol ingestion.
 
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