A 34-year-old pregnant woman with alcohol use disorder presents with fatigue and glossitis. Vital signs show BP 118/76 mmHg, HR 88/min, RR 16/min, temperature 37.2°C, and SpO2 98% on room air. Laboratory studies reveal hemoglobin 9.4 g/dL, MCV 110 fL, hypersegmented neutrophils, elevated homocysteine, and normal methylmalonic acid. Intrinsic factor antibodies are negative. She denies neurologic symptoms. Which of the following is the most likely diagnosis?
- A)Copper deficiency
- B)Warm autoimmune hemolytic anemia
- C)Folate deficiencyGABARITO
- D)Iron deficiency anemia
- E)Vitamin B12 deficiency
Explicação
Folate deficiency is correct. Folate deficiency causes megaloblastic anemia with macrocytosis, hypersegmented neutrophils, and elevated homocysteine. Unlike vitamin B12 deficiency, methylmalonic acid remains normal and neurologic deficits are absent. Ver explicação completa e trilha adaptativa →