A 30-year old epileptic female, Kamla on Phenytoin therapy, developed weakness and fatigue. Blood examination revealed Hb= 4.6 gm. MCV=102 fl and MCH =40 pg/dl. What is the most probable diagnosis?
Hea failure
Iron deficiency anemia
Phenytoin induced agranulocytosis
Megaloblastic anemia
Phenytoin can cause folic acid deficiency resulting in megaloblastic anemia. This is confirmed by raised MCV and MCH in the blood examination. REF: KD TRipathi 8th ed.
Central Nervous system