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D52.0 – Dietary Folate Deficiency Anaemia
D52.0 is the ICD-10 code for dietary folate deficiency anaemia. Insufficient folic acid intake through food impairs red blood cell production, leading to abnormally large blood cells.
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D52.0 is the ICD-10 code for dietary folate deficiency anaemia. Insufficient folic acid intake through food impairs red blood cell production, leading to abnormally large blood cells.
What is D52.0?
D52.0 is the ICD-10 code for dietary folate deficiency anaemia. This is a type of megaloblastic anaemia caused by an inadequate intake of folic acid (vitamin B9) through the diet. When folate levels are too low, the body cannot produce healthy red blood cells. Instead, abnormally large and immature red blood cells – called megaloblasts – are formed, which are unable to function properly.
Causes
The defining cause of D52.0 is an insufficient dietary intake of folic acid. Since the body cannot store folate for long periods, a regular and adequate supply through food is essential.
- Unbalanced or nutrient-poor diet
- Low consumption of vegetables, legumes, and whole grains
- Prolonged cooking of foods, which destroys folic acid
- Excessive alcohol consumption, which interferes with folate absorption
- Increased requirements during pregnancy or breastfeeding
Symptoms
Symptoms of dietary folate deficiency anaemia typically develop gradually and may include:
- Fatigue and weakness (most common symptom)
- Pallor of the skin and mucous membranes
- Shortness of breath and rapid heartbeat, especially during exertion
- Headaches and dizziness
- A sore or inflamed tongue (glossitis)
- Difficulty concentrating and irritability
- In severe cases: tingling in the hands and feet (especially if combined with vitamin B12 deficiency)
Diagnosis
Diagnosis is based on medical history, physical examination, and laboratory tests:
- Full blood count: Elevated mean corpuscular volume (MCV), indicating enlarged red blood cells (macrocytic anaemia)
- Serum folate: Low folate levels in the blood
- Red blood cell folate: A long-term marker of folate status
- Vitamin B12: Tested to rule out concurrent B12 deficiency, which causes similar symptoms
- Blood smear: Reveals megaloblasts and hypersegmented neutrophils
Treatment
Treatment of D52.0 focuses on correcting the folate deficiency and improving dietary habits:
Folic Acid Supplementation
Oral folic acid supplementation is typically prescribed at a dose of 5 mg per day for several weeks until blood values normalise. Milder cases may require lower doses. Treatment should always be supervised by a healthcare professional.
Dietary Modifications
Alongside supplementation, improving the diet is essential. Foods rich in folic acid include:
- Leafy green vegetables (spinach, kale, lettuce)
- Legumes (lentils, beans, chickpeas)
- Whole grain products
- Eggs and liver (in moderation)
- Oranges and orange juice
Addressing Underlying Causes
If additional contributing factors such as alcohol misuse or a severely restricted diet are identified, these must also be addressed to prevent relapse.
Distinction from Other Anaemia Types
D52.0 specifically refers to folate deficiency anaemia caused by dietary insufficiency. Other ICD-10 codes under D52 cover folate deficiency due to malabsorption (D52.1), medications (D52.2), or other causes (D52.8, D52.9). Careful differential diagnosis is therefore important.
References
- World Health Organization (WHO): Nutritional Anaemias: Tools for Effective Prevention and Control. WHO Press, Geneva, 2017.
- Kasper, D.L. et al.: Harrison's Principles of Internal Medicine, 20th Edition. McGraw-Hill Education, 2018.
- National Institutes of Health (NIH) Office of Dietary Supplements: Folate – Fact Sheet for Health Professionals. Available at: ods.od.nih.gov (accessed 2024).
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