{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T12:47:32Z","timestamp":1756385252150,"version":"3.44.0"},"reference-count":8,"publisher":"BMJ","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ Case Reports"],"published-print":{"date-parts":[[2010]]},"abstract":"<jats:p>Folate-deficiency anaemia occurs in about 4 per 100 000 people, although severe cases causing moderate pancytopenia are rarer. We present the case of a significant folate deficiency in a 50-year-old alcoholic with a background of mild liver impairment and recurrent nasal and rectal bleeding. Her blood tests showed profound macrocytic anaemia with haemoglobin 2.6 g\/dl, leucopoenia with white cell count 3.2 \u00d7 10<jats:sup>9<\/jats:sup>\/litre and thrombocytopenia with platelets 17 \u00d7 10<jats:sup>9<\/jats:sup>\/litre. Serum folate was 0.8 ng\/ml (normal 2.5\u201313.5 ng\/ml) confirming severe deficiency.<\/jats:p>\n               <jats:p>Despite these life-threatening results, the patient was stable, alert and was keen to avoid admission. Medical management of the anaemia included slow transfusion of red cells and one unit of platelets in view of haemorrhagic symptoms, two injections of vitamin B12 while awaiting assays and oral folic acid. A rapid improvement in the leucopoenia and thrombocytopenia resulted and no additional complications were encountered.<\/jats:p>","DOI":"10.1136\/bcr.03.2010.2851","type":"journal-article","created":{"date-parts":[[2010,10,21]],"date-time":"2010-10-21T12:18:42Z","timestamp":1287663522000},"page":"bcr0320102851","source":"Crossref","is-referenced-by-count":6,"title":["Severe folate-deficiency pancytopenia: Table 1"],"prefix":"10.1136","volume":"2010","author":[{"given":"Viktoriya","family":"Clarke","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon","family":"Weston-Smith","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2010,10,21]]},"reference":[{"key":"2025082623382232000_2010.oct18_2.bcr0320102851.1","unstructured":"Antony AC . Megaloblastic anemias. In: Goldman L Ausiello D , eds. Cecil Medicine. 23rd edn. Philadelphia, Pennsylvania, USA: Saunders Elsevier, 2007: 1231\u00e2\u0080\u009340."},{"key":"2025082623382232000_2010.oct18_2.bcr0320102851.2","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1111\/j.1365-2141.1975.tb01844.x","article-title":"Folate deficiency in the alcoholic\u00e2\u0080\u0093its relationship to clinical and haematological abnormalities, liver disease and folate stores","volume":"29","author":"Wu","year":"1975","journal-title":"Br J Haematol"},{"key":"2025082623382232000_2010.oct18_2.bcr0320102851.3","doi-asserted-by":"crossref","first-page":"1280","DOI":"10.1016\/S0016-5085(77)80028-0","article-title":"Acute and chronic effects of ethanol on fluid transport in the human small intestine","volume":"72","author":"Mekhjian","year":"1977","journal-title":"Gastroenterology"},{"key":"2025082623382232000_2010.oct18_2.bcr0320102851.4","doi-asserted-by":"crossref","first-page":"526","DOI":"10.1016\/S0016-5085(73)80121-0","article-title":"Intestinal malabsorption in folate-deficient alcoholics","volume":"64","author":"Halsted","year":"1973","journal-title":"Gastroenterology"},{"key":"2025082623382232000_2010.oct18_2.bcr0320102851.5","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.me.33.020182.002021"},{"key":"2025082623382232000_2010.oct18_2.bcr0320102851.6","doi-asserted-by":"publisher","DOI":"10.1016\/0006-2952(85)90092-9"},{"key":"2025082623382232000_2010.oct18_2.bcr0320102851.7","unstructured":"Gentili A Vohra M Vij S Chen DK Siddiqi W . Folic Acid Deficiency. http:\/\/emedicine.medscape.com\/article\/200184-overview. (Accessed 19 September 2007)."},{"key":"2025082623382232000_2010.oct18_2.bcr0320102851.8","doi-asserted-by":"publisher","DOI":"10.1186\/1757-1626-1-275"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr.03.2010.2851","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T06:38:34Z","timestamp":1756276714000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr.03.2010.2851"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2010]]},"references-count":8,"alternative-id":["10.1136\/bcr.03.2010.2851"],"URL":"https:\/\/doi.org\/10.1136\/bcr.03.2010.2851","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2010]]}}}