A 30yr old patient complaints of easy fatigability exotional dyspnea and weight loss She also complaints of frequent fall There is B12 decrease in vibration sense Her Hb levels were low She was treated with folate Her anemia improved but neurological symptoms worsen d Which of the following is most probable reason of her condition
Sb a patient of hit B12 deficiency anemia keeps taking folate the anemia will improve but the neurological symptoms will worsen. ref : harrisons 21st ed
Folate not absorbed
Deficiency of folate reductase in CNS
Unmasked pyridoxine defficiency
Folate therapy caused rapid use of B12 stores aggravating symptoms
All India exam