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Symptoms, Complete blood count, Peripheral blood smear, Vitamin B12 level, Red cell folate level Macrocytosis is a condition where red blood cells are larger than normal. [ 1 ] These enlarged cells, also known as macrocytes, are defined by a mean corpuscular volume (MCV) that exceeds the upper reference range established by the laboratory and ...
In pernicious anemia (macrocytic), MCV can range up to 150 femtolitres. [4] (as are an elevated GGT and an AST/ALT ratio of 2:1). Vitamin B12 and/or folic acid deficiency has also been associated with macrocytic anemia (high MCV numbers).
Folate and vitamin B 12 deficiency anemia usually presents with high RDW and high MCV. Mixed-deficiency (iron + B 12 or folate) anemia usually presents with high RDW and variable MCV. Recent hemorrhages typically present with high RDW and normal MCV. A false high RDW reading can occur if EDTA anticoagulated blood is used instead of citrated blood.
A diagnosis of PA first requires demonstration of megaloblastic anemia by conducting a full blood count and blood smear, which evaluates the mean corpuscular volume (MCV), as well the mean corpuscular hemoglobin concentration (MCHC). [50] PA is identified with a high MCV (macrocytic anemia) and a normal MCHC (normochromic anemia). [54]
Cholestasis can be excluded by normal levels of bile acids in plasma, the absence of lactate dehydrogenase, low levels of conjugated bilirubin, and ultrasound scan of the bile ducts. Vitamin B12 deficiency - elevated bilirubin levels (and MCV counts above 90–92) can be associated with a vitamin B12 deficiency.
Macrocytic anemias have several causes but with the implementation of folic acid fortification in North America, folate deficiency has become a rare cause of megaloblastic macrocytic anemia in that part of the world. [2] In this region, Vitamin B 12 deficiency is a far more common cause of megaloblastic macrocytic anemia. [2]
Polycythemia is defined as serum hematocrit (Hct) or hemoglobin (HgB) exceeding normal ranges expected for age and sex, typically Hct >49% in healthy adult men and >48% in women, or HgB >16.5 g/dL in men or >16.0 g/dL in women. [8]
Decreased red blood cell (RBC) count and hemoglobin levels [7] Increased mean corpuscular volume (MCV, >100 fL) and mean corpuscular hemoglobin (MCH) Normal mean corpuscular hemoglobin concentration (MCHC, 32–36 g/dL) Decreased reticulocyte count due to destruction of fragile and abnormal megaloblastic erythroid precursor. The platelet count ...