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Macrocytic Anemia in Hematology

Diagnostic algorithm for elevated mean corpuscular volume with anemia

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Hematoloji department. Book Appointment →

What is Macrocytic Anemia in Hematology?

Macrocytic anemia presents with elevated mean corpuscular volume, often above one hundred femtoliters, and low hemoglobin. Megaloblastic causes from vitamin B twelve or folate deficiency display hypersegmented neutrophils, oval macrocytes, and elevated lactate dehydrogenase from ineffective erythropoiesis.

Non megaloblastic causes include alcohol use, hypothyroidism, liver disease, drugs that interfere with deoxyribonucleic acid synthesis, and myelodysplastic syndromes. Reticulocytosis from acute blood loss or hemolysis can also raise mean corpuscular volume because of the larger immature red cells.

Workup includes peripheral smear, vitamin B twelve and folate, thyroid function, liver tests, reticulocyte count, and bone marrow examination when myelodysplasia is suspected. Therapy targets the underlying cause and includes vitamin replacement, alcohol cessation, drug review, or specific therapy for myelodysplasia.

Symptoms

Pallor and fatigue with megaloblastic anemia
Glossitis and angular stomatitis
Distal symmetric paresthesias from B twelve deficiency
Cognitive slowing or psychiatric features
Mild jaundice from ineffective erythropoiesis

Risk Factors

Strict vegan diet without supplementation
Pernicious anemia and atrophic gastritis
Bariatric surgery or terminal ileal disease
Chronic alcohol use disorder
Methotrexate or hydroxyurea therapy

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • When mean corpuscular volume rises above one hundred
  • When neuropathy accompanies anemia
  • When pancytopenia is detected
  • When hemolysis markers rise unexpectedly
  • When myelodysplasia is suspected

Treatment Methods

01
Peripheral smear and reticulocyte count
02
Serum B twelve folate and methylmalonic acid
03
Thyroid and liver function tests
04
Bone marrow examination when myelodysplasia is suspected
05
Parenteral or oral vitamin B twelve replacement
06
Folate replacement after B twelve exclusion
07
Treatment of alcohol use and offending drugs

Which Department to Visit?

You can visit our Hematoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.