Question

A 72-year-old vegan man presents with neuropathy and macrocytic anaemia. Laboratory tests show haemoglobin 100 g/L, MCV 112 fL, low serum vitamin B12, and elevated methylmalonic acid. What is the most appropriate treatment?

Accepted Answer

Vitamin B12 replacement with intramuscular hydroxocobalamin or high-dose oral cobalamin

Answer

Folic acid supplementation alone

Answer

Iron supplementation only

Answer

No treatment is required because he is asymptomatic

Answer

Long-term prednisone therapy

Practice question

A 72-year-old vegan man presents with neuropathy and macrocytic anaemia. Laboratory tests show haemoglobin 100 g/L, MCV 112 fL, low serum vitamin B12, and elevated methylmalonic acid. What is the most appropriate treatment?