Cleveland Clinic journal of medicine
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Editorial Comment
The under- and overrecognized, and the elephant in the room.
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Endoscopic ultrasonography (EUS) has been used since the mid-1980s. Initially a diagnostic tool, it has since evolved into a therapeutic, minimally invasive surgical tool with significant impact on the diagnosis and management of a range of benign and malignant conditions. The authors review current indications, safety, and efficacy of EUS for diseases of the upper and lower gastrointestinal tract, posterior mediastinum, pancreas, bile duct, gallbladder, retroperitoneum, liver, adrenal glands, and kidneys.
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Review Case Reports
Severe megaloblastic anemia: Vitamin deficiency and other causes.
Megaloblastic anemia causes macrocytic anemia from ineffective red blood cell production and intramedullary hemolysis. The most common causes are folate (vitamin B9) deficiency and cobalamin (vitamin B12) deficiency. ⋯ However, other benign and neoplastic diseases need to be considered, particularly in severe cases. Therapy involves treating the underlying cause-eg, with vitamin supplementation in cases of deficiency, or with discontinuation of a suspected medication.