Macrocytic anemia history and symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Shyam Patel [2] Associate Editor(s)-in-Chief: Omer Kamal, M.D.[3]
Overview
History may include higher MCV specially in neonates and infants, alcohol use, medications (eg, anticonvulsants, zidovudine, immunosuppressive agents), congenital heart disease, Down syndrome, reticulocytosis, bone marrow failure/dysplasia, liver disease, thyroid disease, hemolytic anemias with reticulocytosis and myelodysplastic syndromes (MDS). Macrocytosis is a common feature of MDS, especially in older adults. Patients with B12 deficiency show neurologic dysfunction, anemia symptoms such as fatigue, dyspnea, lightheadedness, and anorexia, high output cardiac failure, angina, diarrhea, cheilosis, glossitis, subacute combined degeneration, broad based gait, ataxia, numbness or paresthesias, Rhomberg and Babinski’s sign.
History and Symptoms
History[1][2][3]
- Patient age: MCV is higher in neonates and infants[3][4]
- Alcohol
- Medications (eg, anticonvulsants, zidovudine, immunosuppressive agents)
- Congenital heart disease
- Down syndrome
- Reticulocytosis
- Bone marrow failure/dysplasia
- Liver disease, thyroid disease
- Hemolytic anemias with reticulocytosis and myelodysplastic syndromes (MDS)
- Macrocytosis is a common feature of MDS, especially in older adults
Symptoms[5][6][7]
- Neurologic dysfunction from B12 deficiency
- Fatigue
- Dyspnea
- Lightheadedness
- Anorexia
- High output cardiac failure
- Angina
- Diarrhea
- Cheilosis
- Glossitis
- Subacute combined degeneration
- Broad based gait
- Ataxia
- Numbness or paresthesias
- Rhomberg and Babinski’s sign
- Dementia may progress to frank “megaloblastic madness”
References
- ↑ Christensen RD, Jopling J, Henry E, Wiedmeier SE (January 2008). "The erythrocyte indices of neonates, defined using data from over 12,000 patients in a multihospital health care system". J Perinatol. 28 (1): 24–8. doi:10.1038/sj.jp.7211852. PMID 17972890.
- ↑ Dallman PR, Siimes MA (January 1979). "Percentile curves for hemoglobin and red cell volume in infancy and childhood". J. Pediatr. 94 (1): 26–31. PMID 758417.
- ↑ 3.0 3.1 Pappo AS, Fields BW, Buchanan GR (June 1992). "Etiology of red blood cell macrocytosis during childhood: impact of new diseases and therapies". Pediatrics. 89 (6 Pt 1): 1063–7. PMID 1534402.
- ↑ Aslinia F, Mazza JJ, Yale SH (September 2006). "Megaloblastic anemia and other causes of macrocytosis". Clin Med Res. 4 (3): 236–41. PMC 1570488. PMID 16988104.
- ↑ Davenport J (January 1996). "Macrocytic anemia". Am Fam Physician. 53 (1): 155–62. PMID 8546042.
- ↑ Anttila P, Ihalainen J, Salo A, Heiskanen M, Juvonen E, Palotie A (August 1995). "Idiopathic macrocytic anaemia in the aged: molecular and cytogenetic findings". Br. J. Haematol. 90 (4): 797–803. PMID 7669657.
- ↑ Rauw J, Wells RA, Chesney A, Reis M, Zhang L, Buckstein R (October 2011). "Validation of a scoring system to establish the probability of myelodysplastic syndrome in patients with unexplained cytopenias or macrocytosis". Leuk. Res. 35 (10): 1335–8. doi:10.1016/j.leukres.2011.05.001. PMID 21704372.