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{{Macrocytic anemia}}
{{Macrocytic anemia}}
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==Overview==
==Overview==
'''Macrocytosis''' is the enlargement of [[red blood cell]]s with near-constant [[haemoglobin]] concentration, and is defined by a [[mean corpuscular volume]] (MCV) of greater than 100 femtolitres (the precise criterion varies between laboratories).  
[[Macrocytic anemia]] are the [[anemia]] which has MCV>100fL. [[Macrocytic anemia]] may be classified into 2 subtypes/groups: [[Megaloblastic anemia]] and  non megaloblastic anemia.
 
==Classification==
==Classification==
===Megaloblastic anemias (DNA replication disorders)===
* [[Macrocytic anemia]] are the anemia which has MCV>100fL
* Commonest cause of macrocytic anemia.
* In [[megaloblastic anemia]]s cells are larger because they cannot produce DNA quickly enough to divide at the right time as they grow, and thus grow too large before division.
* Causes for the DNA synthetic problem range from lack of certain vitamins needed to produce DNA (notably [[folate]] and [[B12]]), to poisons or inhibitors of DNA replication, such as some kinds of antiviral drugs and chemotherapeutic agents.
* The pathognomonic findings of megaloblastic anemia are: megaloblasts in [[bone marrow]], ovalocytes in the (peripheral) blood smear, and hypersegmented [[neutrophils]].
 
===Non megaloblastic macrocytic anemias===
* Non megaloblastic macrocytic anemias, are disorders associated with increased red cell membrane surface area
* It is commonly associated with pathologies of the liver and spleen which produce [[codocyte]]s or "target cells" which have a central collection of hemoglobin surrounded by a pallor (a thin area) then followed by a thicker collection of hemoglobin at the rim of the cell.
 
===Alcohol===
* Round macrocytes which are not codocytes are produced in chronic alcoholism (which produces a mild macrocytosis even in the absence of vitamin deficiency), apparently as a direct toxic effect of alcohol specifically on the bone marrow.


===Association with rapid red cell turnover and reticulocytosis===
* [[Macrocytic anemia]] may be classified into 2 subtypes/groups:<ref name="NaeimNagesh Rao2013">{{cite journal|last1=Naeim|first1=Faramarz|last2=Nagesh Rao|first2=P.|last3=Song|first3=Sophie X.|last4=Grody|first4=Wayne W.|title=Disorders of Red Blood Cells—Anemias|year=2013|pages=675–704|doi=10.1016/B978-0-12-385183-3.00061-9}}</ref><ref name="Erber2011">{{cite journal|last1=Erber|first1=WN|title=Investigation and classification of anemia|year=2011|pages=105–113|doi=10.1016/B978-0-7020-3147-2.00006-7}}</ref><ref name="pmid19787825">{{cite journal |vauthors=Moreno Chulilla JA, Romero Colás MS, Gutiérrez Martín M |title=Classification of anemia for gastroenterologists |journal=World J. Gastroenterol. |volume=15 |issue=37 |pages=4627–37 |date=October 2009 |pmid=19787825 |pmc=2754510 |doi= |url=}}</ref>
Mild macrocytocis is a common finding associated with rapid blood restoration or production, since in general, "fresh" or newly-produced red cells ([[reticulocytes]]) are larger than the mean (average) size, due to slow shrinkage of normal cells over a normal red cell circulating lifetime. Thus, [[chronic obstructive pulmonary disease]] (COPD), in which which red cells are rapidly produced in response to low oxygen levels in the blood, often produces mild macrocytosis. Also, rapid blood replacement from the marrow after a traumatic blood loss, or rapid red blood cell turnover from rapid hemolysis, also often produces mild macrocytosis in the associated anemia.
** [[Megaloblastic anemia]]
*** [[Vitamin B12 deficiency]]
*** [[Folate deficiency]]  
** Non megaloblastic anemia
*** Intrinsic (Myelodyplasia)  
*** Extrinsic ([[liver disease]], [[hypothyroidism]])


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
[[es:Anemia megaloblástica]]
 
[[gl:Anemia megaloblástica]]
[[he:אנמיה מגלובלסטית]]
[[it:Anemia megaloblastica]]
[[pl:Niedokrwistość megaloblastyczna]]
[[pt:Anemia megaloblástica]]
[[ru:Пернициозная анемия]]
[[sl:Megaloblastna anemija]]
[[sr:Мегалобластна анемија]]
[[tr:Megaloblastik anemi]]


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Latest revision as of 18:27, 6 November 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Amandeep Singh M.D.[2], Omer Kamal, M.D.[3]

Overview

Macrocytic anemia are the anemia which has MCV>100fL. Macrocytic anemia may be classified into 2 subtypes/groups: Megaloblastic anemia and non megaloblastic anemia.

Classification

References

  1. Naeim, Faramarz; Nagesh Rao, P.; Song, Sophie X.; Grody, Wayne W. (2013). "Disorders of Red Blood Cells—Anemias": 675–704. doi:10.1016/B978-0-12-385183-3.00061-9.
  2. Erber, WN (2011). "Investigation and classification of anemia": 105–113. doi:10.1016/B978-0-7020-3147-2.00006-7.
  3. Moreno Chulilla JA, Romero Colás MS, Gutiérrez Martín M (October 2009). "Classification of anemia for gastroenterologists". World J. Gastroenterol. 15 (37): 4627–37. PMC 2754510. PMID 19787825.


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