by. Ana Sirley Calderon Flores. on 11 November Comments (0). Please log in to add your comment. Report abuse. Transcript of ANEMIA MACROCITICA. Megaloblastosis can be associated with severe anemia and pancytopenia, gastrointestinal dysfunction and glossitis, personality changes. Macrocytosis without anemia may be a normal variant and is only noted as a result of repeated peripheral RBC indices in the absence of any known or existing.
|Published (Last):||7 April 2010|
|PDF File Size:||2.43 Mb|
|ePub File Size:||13.86 Mb|
|Price:||Free* [*Free Regsitration Required]|
Loss of micronutrients may also be a cause. This time-honored method remains an acceptable form of treatment for all causes of vitamin B12 deficiency, particularly when cognitive impairment or neurologic disease is present.
Chanarin I, Metz J. However, routine ordering of this test as part of the work-up to establish the diagnosis of vitamin B12 deficiency is not currently recommended.
The bone marrow is hypercellular, showing evidence of abnormal proliferation and maturation of multiple mwcrocitica cell lines. Acknowledgments The authors are grateful to Marian Menn and Veronica Tillema for providing the figures of macrocytosis in the peripheral blood smear. However, the metabolism of L-methylmalonyl CoA to succinyl CoA, an enzymatic pathway involved in oxidative phosphorylation reactions within the cell, mqcrocitica requires vitamin B What is the clinical utility of obtaining a folate level in patients with macrocytosis or anemia?
Evaluation of macrocytosis begins with a complete history and physical examination to search for signs and symptoms related to an acute anekia chronic underlying illness that may be obvious or occult in nature.
Reticulocyte Count A reticulocyte count should be obtained if there is evidence of hemolysis on the peripheral smear, i.
Parietal cell antibodies, although not specific, are also commonly present. In some instances this variation from normal can be found in other family members, which suggests a genetic predisposition, and requires no therapeutic intervention or further investigation.
Find articles by Joseph J.
Clin Lab Med ; Diagnosis of cobalamin deficiency: Determining anemi underlying cause of the macrocytosis can be particularly challenging when thalassemia trait or iron deficiency or other nutritional deficiencies coexist with a vitamin B12 or folate deficiency. Hypovitaminosis B 12 can result from a number of mechanisms, including those listed above. Alternatively, hydroxocobalamin given in the same dose every 1—3 months intramuscularly is also effective therapy.
More severe degrees of abnormal proliferation and maturation are seen with myelodysplasia and myeloid leukemias. Although determination of the MCV by automated macrocigica cell counter is rarely inaccurate, hyperglycemia, marked leukocytosis and cold agglutinins may result in false elevations of the MCV.
J Clin Pathol ; Acta Med Scand ; Anemia is a condition in which the body does not have enough healthy red blood cells.
Postgrad Med J ; This abnormality marocitica usually recognized by the automated blood cell counter and confirmed on review of the peripheral blood smear.
Normal MCV values range from 80 to femtoliters fl and vary by age and reference laboratory. Megaloblastic anemia is a blood disorder in which there is anemia with larger-than-normal red blood cells.
The authors thank Marshfield Clinic Research Foundation for its support through the assistance of Jennifer Hayes and Alice Stargardt in the preparation of this article. Please review the contents of the article and add the appropriate references if you can. Is there a role for folate determinations in current clinical practice in the USA?
Br J Clin Pharmacol ; The evaluation of the patient with macrocytosis requires a systemic approach.
Megaloblastic Anemia and Other Causes of Macrocytosis
Megaloblastic anemia not due to hypovitaminosis may be caused by antimetabolites that poison DNA production directly, such as some chemotherapeutic or antimicrobial agents for example azathioprine or trimethoprim. Drugs Alcoholism Reticulocytosis Nonalcoholic and alcoholic liver disease Hypothyroidism Vitamin B12 deficiency Folate deficiency Multiple myeloma Myelodysplastic syndromes Aplastic anemia Acute leukemia.
Macrocytosis is frequently linked to alcoholism, with or without liver disease. Laboratory diagnosis of vitamin B12 and folate deficiency: Publicar un comentario Este es un blog dirigido a profesionales sanitarios.
Pages containing links to subscription-only content Articles needing additional medical references from September All articles needing additional references Articles requiring reliable medical sources Infobox medical condition All articles with unsourced statements Articles with unsourced statements from July Articles with unsourced statements from December Clin Lab Haematol ; Due to the lack of available radioactive Vitamin B 12the Schilling test is now largely a historical artifact.
Serum MMA will be elevated in patients with underlying renal dysfunction, decreasing its specificity and sensitivity in identifying patients with cobalamin deficiency.