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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 ...
The mean corpuscular volume is a part of a standard complete blood count. In patients with anemia, it is the MCV measurement that allows classification as either a microcytic anemia (MCV below normal range), normocytic anemia (MCV within normal range) or macrocytic anemia (MCV above normal range). Normocytic anemia is usually deemed so because ...
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.
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]
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 ...
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]
The mean corpuscular volume or MCV is usually normal or low for congenital causes of sideroblastic anemia but normal or high for acquired forms. With lead poisoning, see coarse basophilic stippling of red blood cells on peripheral blood smear; Specific test: Prussian blue stain of RBC in marrow shows ringed sideroblasts.
MCHC can be normal even when hemoglobin production is decreased (such as in iron deficiency) due to a calculation artifact. MCHC can be elevated ("hyperchromic") in hereditary spherocytosis, sickle cell disease and homozygous hemoglobin C disease, depending upon the hemocytometer. [4] [5] MCHC can be elevated in some megaloblastic anemias. MCHC ...