Assessment 

On observation of a child with this type of anaemia you will find that in addition to the symptoms  of iron deficiency anaemia there is hyper-pigmentation over knuckles of hands and feet and on extensor surface of arms and legs. There is bleeding  tendency, glossitis and increased frequency of infection. On palpation, there may be hepatosplenomegaly. Diagnostic evaluation includes peripheral blood smear which shows changes in red cell morphology  and leukocytes. Bone marrow reveals characteristic megaloblast  form of the nucleated red cells.