macrocytic anemia
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Etiology
- pure red cell aplasia
- liver disease, alcoholism
- aplastic anemia
- megaloblastic anemia
- hemolytic anemia
- sideroblastic anemia*
- cold agglutinin disease
- hypothyroidism
- pharmaceutical agents
- interference with folate metabolism
- inhibition of purine or pyrimidine synthesis
- inhibition of deoxyribonucleotide synthesis
* MKSAP17 classifies sideroblastic anemia as macrocytic anemia; a dimorphic population of erythrocytes is observed, some are macrocytic, others hypochromic & microcytic
Laboratory
- complete blood count (CBC)
- perpheral smear
- target cells with MCV of 105-110 fL & acanthocytes (spur cells with spicules) suggest liver disease & hyposplenism
- see megaloblastic anemia
- anemia associated with MCV > 115 fL rules in megaloblastic anemia[3]
More general terms
More specific terms
Additional terms
- 5-fluorouracil [5-FU] (Fluoroplex, Efudex, Adrucel, Carac)
- aplastic anemia
- azathioprine (Azanin, Imuran, Imurel)
- cold agglutinin
- cytosine arabinoside; cytarabine (Cytosar, ARA-C, HiDAC, Depocyt)
- deoxyribonucleotide
- hemolytic anemia
- hydroxyurea; hydroxycarbamide (Hydrea, Droxia)
- hypothyroidism
- methotrexate (Rheumatrex, MTX)
- oral contraceptive (OC)
- phenobarbital; PB; PHB (Luminal, Barbita, Solfoton)
- phenytoin; diphenylhydantoin; PTN (Dilantin, Dephenylan, Antilepsin)
- primidone; desoxyphenobarbital (Primaclone, Mysoline)
- purine
- pyrimidine
- sulfamethoxazole [SMX] (Gantanol, Aposulfatrim, Bactoreduct)
- sulfasalazine (SSZ, Azulfidine, SAS)
- triamterene (Dyrenium)
- zidovudine; azidothymidine; AZT (Retrovir)
References
- ↑ Mayo Internal Medicine Board Review, 1998-99, Prakash UBS (ed) Lippincott-Raven, Philadelphia, 1998, pg 411
- ↑ Schiller G, in: UCLA Intensive Course in Geriatric Medicine & Board Review, Marina Del Ray, CA, Sept 12-15, 2001
- ↑ 3.0 3.1 Medical Knowledge Self Assessment Program (MKSAP) 14, 16, 17, 18. American College of Physicians, Philadelphia 2006, 2012, 2015, 2018.
Medical Knowledge Self Assessment Program (MKSAP) 19 Board Basics. An Enhancement to MKSAP19. American College of Physicians, Philadelphia 2022 - ↑ Galloway M, Hamilton M. Macrocytosis: pitfalls in testing and summary of guidance. BMJ. 2007 Oct 27;335(7625):884-6. PMID: https://www.ncbi.nlm.nih.gov/pubmed/17962289
- ↑ Green R, Dwyre DM. Evaluation of Macrocytic Anemias. Semin Hematol. 2015 Oct;52(4):279-86. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/26404440
- ↑ 6.0 6.1 6.2 NEJM Knowledge+ Hematology