Investigation

Peripheral blood film - megaloblastic anaemia

Bone marrow - megaloblastic erythropoesis.

Investigation of underlying causes of B12 deficiency is essential:

- Radioactive BJ2 absorption tests.

- Endoscopy and biopsy.

- Barium meal and follow through.

- Investigation of small intestine function.

MRI may show high signal changes on T2 weight images of the spinal cord. Treatment

When neurological dysfunction is present vit. B12 therapy must be started promptly - 1000 Hg cyanocobalamin daily for several weeks and monthly thereafter.

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