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D52.9 – Folate Deficiency Anaemia | ICD-10
D52.9 is an ICD-10 code for folate deficiency anaemia, unspecified. It describes a form of anaemia caused by insufficient folic acid, impairing healthy red blood cell production.
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D52.9 is an ICD-10 code for folate deficiency anaemia, unspecified. It describes a form of anaemia caused by insufficient folic acid, impairing healthy red blood cell production.
What is D52.9?
D52.9 is an ICD-10 diagnosis code for folate deficiency anaemia, unspecified. This means that a blood test has revealed anaemia (a reduced number or quality of red blood cells) caused by a lack of folic acid (vitamin B9), without a specific underlying cause being documented. Folic acid is an essential B vitamin required for cell division and the production of healthy red blood cells.
Causes
Folate deficiency leading to anaemia can result from several factors:
- Dietary deficiency: Insufficient intake of folate-rich foods such as leafy green vegetables, legumes, and whole grains
- Increased demand: During pregnancy, breastfeeding, or periods of rapid growth
- Malabsorption: Impaired absorption in the small intestine due to conditions such as coeliac disease or Crohn's disease
- Alcohol misuse: Alcohol interferes with folate absorption and metabolism
- Medications: Certain drugs such as methotrexate or antiepileptic agents can deplete folate levels
- Increased losses: For example, in patients undergoing haemodialysis
Symptoms
The symptoms of folate deficiency anaemia develop gradually and are similar to those of other types of anaemia:
- Fatigue, exhaustion, and general weakness
- Pale skin and mucous membranes
- Shortness of breath during physical activity
- Palpitations or rapid heartbeat
- Headaches and difficulty concentrating
- Mouth sores (stomatitis) and tongue inflammation (glossitis)
- Enlarged red blood cells in the blood count (macrocytic anaemia)
Diagnosis
Diagnosis is based on clinical assessment and laboratory testing:
- Complete blood count (CBC): Reveals macrocytic anaemia with an elevated MCV (mean corpuscular volume)
- Serum folate: Low folate levels in the blood (normal range approximately 7–45 nmol/l)
- Red blood cell (RBC) folate: Reflects long-term folate status more accurately than serum levels
- Vitamin B12 level: Measured to rule out coexisting vitamin B12 deficiency, which causes a similar blood picture
- Homocysteine: Elevated levels are associated with folate deficiency
Treatment
Treatment is directed at the underlying cause and typically includes:
- Folic acid supplementation: Usually oral administration of 1–5 mg of folic acid daily, depending on the severity of the deficiency and the underlying condition
- Dietary modification: Increasing intake of folate-rich foods such as spinach, broccoli, legumes, and whole grains
- Treatment of the underlying condition: In cases of malabsorption or other specific causes, targeted therapy is essential
- Medication review: If drugs are contributing to the deficiency, dose adjustment or substitution may be considered
With consistent treatment, blood counts typically return to normal within 2–4 months.
References
- World Health Organization (WHO): Nutritional Anaemias: Tools for Effective Prevention and Control. Geneva: WHO, 2017.
- Antony AC: Megaloblastic Anemias. In: Hoffman R et al. (eds.): Hematology: Basic Principles and Practice, 7th ed. Elsevier, 2018.
- National Institutes of Health (NIH), Office of Dietary Supplements: Folate – Fact Sheet for Health Professionals. Updated 2023. Available at: https://ods.od.nih.gov/factsheets/Folate-HealthProfessional/
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