AKT-2997

AKT-2997

A 70-year-old man is brought to surgery with confusion and pallor. His son reports that he has been getting more confused and tired for the past two months. Blood tests are reported as follows:

Hb 9.2 g/dl
MCV 120 fl
Plt 152 * 109/l
WBC 4.8 * 109/l

In light of the macrocytic anaemia some further tests are ordered:

Intrinsic factor antibodies Negative
Vitamin B12 90 ng/l (200-900 ng/l)
Folic acid 1.3 nmol/l (> 3.0 nmol/l)

What is the most appropriate management?