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Macrocytosis--an Australian general practice perspective.
Stella Elisabeth Rumsey1, Bevan Hokin, Parker John Magin
1baysurgery.com.au
Australian Family Physician
|July 11, 2007
Summary
Red blood cell macrocytosis, indicated by elevated mean corpuscular volume (MCV), is common in Australian general practice. Further investigation is crucial as it can signal underlying disease, with alcohol and vitamin B12 deficiency being frequent causes.
Area of Science:
- Hematology
- General Practice
- Clinical Pathology
Background:
- Clinician approaches to identifying and investigating red blood cell macrocytosis vary.
- Limited literature exists on the Australian primary care approach to macrocytosis.
Purpose of the Study:
- To investigate the prevalence of red blood cell macrocytosis in an Australian urban general practice.
- To survey general practitioners' (GPs) approaches to investigating macrocytosis.
Main Methods:
- Calculated mean corpuscular volume (MCV) from blood counts in an urban Australian general practice.
- Surveyed GPs in the surrounding division regarding their experience and investigation methods for macrocytosis.
Main Results:
- 1.7% of patients had MCV > 100 fL; 7.3% had MCV > 96 fL.
- 94% of surveyed GPs investigate macrocytosis, especially when MCV > 100 fL.
- Alcohol excess and vitamin B12 deficiency were the most common causes identified by GPs.
Conclusions:
- Macrocytosis is a significant potential marker for disease requiring identification and investigation.
- Further research is needed to establish definitive reference ranges for healthy adults in general practice.
- Evidence-based clinical guidelines for investigating isolated macrocytosis are necessary.
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