A 35-year old patient with severe anemia, has a peripheral blood smear with oval macrocytes, hypersegmented neutrophils, and decreased platelets and is found to be a severely malnourished alcoholic. The most likely cause of this disorder is?

- Features given in the question suggests the diagnosis of Megaloblastic anemia resulting from chronic alcoholism (folate deficiency) - Megaloblastic anemia associated with severe malnutrition is d/t folate & Vit B12 deficiency Pernicious anemia results from an autoimmune attack on the gastric mucosa and thought to have a strong genetic predisposition. Histologically, there is a chronic atrophic gastritis marked by a loss of parietal cells, a prominent infiltrate of lymphocytes and plasma cells, and megaloblastic changes in mucosal cells similar to those found in erythroid precursors. This leads to defective absorption of vitamin B12 due to lack of intrinsic factor produced by parietal cells. disease of older adults; the median age at diagnosis is 60 years, and it is rare in people younger than 30 years of age.