Megaloblastic Anemia · Pathology

In a patient with megaloblastic anemia, why might serum lactate dehydrogenase (LDH) and indirect bilirubin be elevated?

  1. Concurrent viral hepatitis
  2. Ineffective erythropoiesis and intramedullary destruction of RBC precursors
  3. Direct toxic effect of methylmalonic acid on the liver
  4. Secondary iron deficiency
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Correct answer: Ineffective erythropoiesis and intramedullary destruction of RBC precursors

Megaloblastic anemia is characterized by ineffective erythropoiesis. The destruction of fragile megaloblastic precursors within the bone marrow releases LDH and hemoglobin (which breaks down into indirect bilirubin) into the plasma.

Difficulty: Medium Question 14 of 20

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