{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,26]],"date-time":"2025-04-26T04:04:56Z","timestamp":1745640296405,"version":"3.40.4"},"reference-count":0,"publisher":"Jaypee Brothers Medical Publishing","issue":"05","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAPI"],"published-print":{"date-parts":[[2023,5,7]]},"abstract":"<jats:p>Background: Anemia-causing fever has been described in patients with megaloblastic anemia.  Although the exact mechanism of this is unknown, high-grade fever is relatively less reported. Materials and methods: This prospective observational study included all new cases of  megaloblastic anemia presenting with febrile illness (&gt;101\u00b0F) during a 3-year period. Patients  with existing anemia, comorbidities, and other causes of macrocytosis were excluded. A detailed  evaluation for megaloblastic anemia and workup for excluding tropical infections was done. The  patients were treated with parenteral vitamin B12, folic acid, and other hematinics. Results: Around 24 cases of megaloblastic anemia presenting with high-grade fever were  included, with 14 (58.3%) males, mean duration of fever 7.7 days (4\u201318 days), and 09 (37.5%)  having temperature &gt;103\u00b0F. The mean hemoglobin (Hb) was 8.15 g\/dL (3.7\u201311.1 g\/dL), the mean  corpuscular volume (MCV) was 111 \u00b1 7.8 fL, 18 (75%) had unconjugated hyperbilirubinemia,  the mean lactate dehydrogenase (LDH) was 814 \u00b1 24 IU\/L, and 21 (87.5%) had low B12 or folate  levels. Most showed good therapeutic response to B12 or folic acid with defervescence in 1\u20135 days  (mean 2.6 days) and improvement in lab parameters in 1 week. The study population was divided  into those with temperature \u2265103\u00b0F, and temperature &lt;103\u00b0F it was seen that there was a significant  association (p &lt; 0.05) with leucocyte count of \u22643000\/cumm, and MCV \u2265110 fL, in patients with  temperature \u2265103\u00b0F. Conclusion: Megaloblastic anemia should be considered in the differentials of a patient presenting  with a febrile illness with no clinical localization and a negative initial fever workup. Early  identification and prompt therapy of this easily treatable disorder are very essential.<\/jats:p>","DOI":"10.5005\/japi-11001-0222","type":"journal-article","created":{"date-parts":[[2023,6,13]],"date-time":"2023-06-13T06:35:10Z","timestamp":1686638110000},"page":"70-74","source":"Crossref","is-referenced-by-count":0,"title":["Clinico-laboratory Profile and Outcomes of Megaloblastic  Anemia presenting as Severe Pyrexial Illness mimicking  Tropical Infection"],"prefix":"10.59556","volume":"71","author":[{"given":"Vineet","family":"Behera","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rajiv","family":"Kumar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chaturbhuj","family":"Agrawal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rajan","family":"Kapoor","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Navjyot","family":"Kaur","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Velu","family":"Nair","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2914","published-online":{"date-parts":[[2023,5,1]]},"container-title":["Journal of the Association of Physicians of India"],"original-title":[],"deposited":{"date-parts":[[2025,4,25]],"date-time":"2025-04-25T10:57:34Z","timestamp":1745578654000},"score":1,"resource":{"primary":{"URL":"https:\/\/japi.org\/article\/files\/JAPI0222_p70-74_compressed.pdf"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,1]]},"references-count":0,"journal-issue":{"issue":"05","published-online":{"date-parts":[[2023,5,1]]},"published-print":{"date-parts":[[2023,5,7]]}},"URL":"https:\/\/doi.org\/10.5005\/japi-11001-0222","relation":{},"ISSN":["0004-5772"],"issn-type":[{"type":"print","value":"0004-5772"}],"subject":[],"published":{"date-parts":[[2023,5,1]]}}}