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Macrocytosis as an indicator of human disease
1South Mountain Family Practice, Bethlehem, PA 18005.
Abstract:
Adult patients with macrocytosis, defined as a mean corpuscular volume (MCV) greater than 100 femtoliters, were studied to assess the importance of an elevated MCV. After eliminating pregnant and postpartum patients and patients receiving medications known to cause macrocytosis (e.g., phenytoin, zidovudine, and chemotherapeutic agents), 80 patients were identified and studied. Sixty-seven diagnoses were made in 56 patients. These diagnoses were, in descending order: alcoholism, hematological disorders, habitual drinking, B12 deficiency, chronic liver disease, folic acid deficiency, hypothyroidism, anorexia nervosa, and reticulocytosis. While an elevated MCV is neither sensitive nor specific for any one disease state, an elevated MCV should raise suspicions of underlying pathology.
Insights
An elevated mean corpuscular volume (MCV) in adults can indicate underlying health issues. This study identified common causes like alcoholism, B12 deficiency, and liver disease, highlighting the importance of investigating high MCV levels.
Area of Science:
- Hematology
- Internal Medicine
Background:
- Macrocytosis, characterized by an elevated mean corpuscular volume (MCV) > 100 fL, is a common finding in adult patients.
- The clinical significance of macrocytosis requires careful evaluation to exclude various pathological conditions.
Purpose of the Study:
- To assess the diagnostic importance of an elevated MCV in adult patients.
- To identify the spectrum of diseases associated with macrocytosis after excluding specific confounding factors.
Main Methods:
- Retrospective study of adult patients with macrocytosis (MCV > 100 fL).
- Exclusion criteria included pregnancy, postpartum status, and use of medications known to induce macrocytosis.
- Analysis of diagnoses in the identified patient cohort.
Main Results:
- Eighty patients were studied after exclusions.
- Sixty-seven diagnoses were established in 56 patients.
- The most frequent diagnoses included alcoholism, hematological disorders, habitual drinking, vitamin B12 deficiency, chronic liver disease, folic acid deficiency, hypothyroidism, anorexia nervosa, and reticulocytosis.
Conclusions:
- An elevated MCV is not specific to any single disease but serves as a crucial indicator of potential underlying pathology.
- Investigation of macrocytosis is warranted to diagnose conditions such as alcoholism, nutritional deficiencies, and liver disease.