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![Hyperhomocysteinemia in Megaloblastic anemia][1]

There is a block in conversion of homocysteine to methionine resulting in hyperhomocysteinemia. Premature atherosclerosis and thromboembolism occurs - due to ↑ plasma  homocysteine (increased plasma homocysteine found in 40% of all  atherosclerosis patients). Hence, there is an increased risk of cardiovascular diseases in megaloblastic anemia.

The mechanism of atherosclerosis associated with homocystinuria is shown below:

![atherosclerosis in homocystinuria][2]

[1]: http://ars.els-cdn.com/content/image/1-s2.0-S0920121100001017-gr1.gif
[2]: https://lh3.googleusercontent.com/-cM1A6M0pbi4/UArKEVrDSZI/AAAAAAAABPE/Ll4-30yGQSM/s600/homocysteine%2520atherosclerosis.gif
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