tess
Forum Guru
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In kaplan IM hematology, about macrocytic anemia, there is:
although macrocytosis can occur with hemolysis, liver disease, and myelodisplasia, these give round macrocytes. B12 and folate deficneyc give oval macrocytes.
I didn't know this before. Anyone would like add comment on this? Have you seen any question about this before? Thanks.
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| daira
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In hemolysis, increased reticulocytes may give a picture of macrocytic anemia as 'mean' corpuscular volume is increased. These retics are round.
B12 / Folate deficiency gives rise to megaloblasts, which are oval in shape.
I think this might be an explanation.
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| BellKicker
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This is how I look at it:
You've got macrocytic anemia. To get closer to the diagnosis, you gotta find out whether it's plain macrocytic or megaloblastic anemia.
You could do a bone marrow to find out but there are clues on peripheral smears, too:
Hypersegmented PMNs point to megaloblastic.
Ovalocytes (these are erythrocytes, blasts)
Very high MCV
Some clues would make you think of non-megaloblastic macrocytic anemia, such as
high retic count (retics are larger than erythrocytes, so the MCV gets jacked up)
Bilobed PMNs (myelodysplastic syndrome)
Abnormal liver function tests (alcohol or lever disease)
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| tess
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I got more understanding about this. Thank you both of you so much.
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