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?
High-Yield Explanation
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.