Medical history (history of illness) represents an important component in the diagnosis of megaloblastic anemia.
Family History
- Is there a history of frequent cardiovascular disease/blood disorders in your family?
Social history
Current medical history/systemic history (somatic and psychological complaints).
- Have you noticed symptoms such as a general decrease in performance, dizziness, or palpitations?
- Have you noticed gastroenterological symptoms such as burning of the tongue, loss of appetite, or diarrhea?
- Have you noticed symptoms affecting the nervous system, such as sensory disturbances, muscle weakness, or forgetfulness?
Vegetative anamnesis including nutritional anamnesis.
- Do you eat a balanced and varied diet?
- Do you eat meat and meat products regularly?
- Do you drink alcohol? If so, what drink(s) and how many glasses per day?
- Do you use drugs? If yes, what drugs and how often per day or per week?
Self history incl. medication history.
- Pre-existing conditions (cardiovascular disease; blood disorders).
- Operations
- Allergies
- Pregnancies
Medication history
Anemia
- Antiprotozoal drugs
- Analogue of the azo dye trypan blue (suramin).
- Pentamidine
- Chelating agents (D-penicillamine, trieethylenetetramine dihydrochloride (Trien), tetrathiomolybdenum).
- Direct factor Xa inhibitor (rivaroxaban).
- Immunosuppressants (thalidomide).
- Janus kinase inhibitors (ruxolitinib).
- Monoclonal antibodies – pertuzumab
- MTOR inhibitors (everolimus, temsirolimus).
- Neomycin
- P-aminosalicylic acid (mesalazine)
- Phenytoin [megaoblastic anemia]
- Thrombin inhibitor (dabigatran)
- Tuberculostatics (isoniazid, INH; rifampicin, RMF;
- Antivirals
- Nucleoside analogues (ribavirin) [hemolytic anemia.]
- NS5A inhibitors (daclatasvir).
- Protease inhibitors (boceprevir, telaprevir).
Aplastic anemia
- Allopurinol*
- Alpha-methyldopa*
- Antibiotics – drugs such as streptomycin* , tetracycline* or methicillin* .
- Antidiabetic drugs – tolbutamide and chlorpropamide.
- Antihistamines – cimetidine
- Anticonvulsants – carbomazepine
- Carboanhydrase inhibitors (CAH, CAI) – acetazolamide, dichlorophenamide, methazolamide.
- Quinidine*
- Chloramphenicol
- Colchicine
- D-penicillamine – drug used in the therapy of rheumatoid arthritis.
- Lithium*
- Medicines for protozoan infections such as chloroquine or mepacrine.
- Non-steroidal anti-inflammatory drugs (NSAIDs) – phenylbutazone, ibuprofen, or acetylsalicylic acid (ASA).
- Estrogens
- Sedatives – such as chlorpromazine* or meprobamate* .
- Sulfonamides
- Tuberculostatics (isoniazid, INH)
- Thyrostatic drugs – such as methylthiouracil or carbimazole.
- Cytostatics
- Alkylants such as chlorambucil or cyclophosphamide.
- Antimetabolites such as mercaptopurine, fluorouracil or methotrexate.
- Mitosis inhibitors such as vincristine or paclitaxel.
Note: For drugs marked with an asterisk (* ), the association with aplastic anemia is poorly established.
