Macrocytic anemia differential diagnosis: Difference between revisions

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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]

Overview

Megaloblastic anemia needs to be diffrentiated from other causes of anemia.

Differentiating Macrocytic Anemia from Other Diseases

To review the differential diagnosis of anemia, click here.

Disease	Genetics	Clinical manifestation					Lab findings
		History	Symptoms	Signs	Hemolysis	Intrinsic/Extrinsic	Hb concentration	MCV	RDW	Reticulocytosis	Haptoglobin levels	Hepcidin	Iron studies					Specific finding on blood smear
		History	Symptoms	Signs	Hemolysis	Intrinsic/Extrinsic	Hb concentration	MCV	RDW	Reticulocytosis	Haptoglobin levels	Hepcidin	Serum iron	Serum Tfr level	Transferrin or TIBC	Ferritin	Transferrin saturation	Specific finding on blood smear
Folate deficiency^[1]	Impaired DNA synthesis	Alcohol consumption History of using drugs like methotrexate, trimethoprim, and phenytoin Low socioeconomic groups with poor nutrition Older people Pregnant and lactating women	No neurological symptoms vs B12 deficiency Odynophagia Angular stomatitis	Glossitis Signs of heart failure Anencephaly and spina bifida	−	−	Anisochromic	Macrocytic	↑	↓	Nl	Nl	↑	↑	↓	↑	↑	RBC macrocytosis Hypersegmented neutrophils Pancytopenia in severe cases
Vitamin B12 deficiency^[2]	Impaired DNA synthesis	Pernicious anemia Crohn's disease Gastrectomy Veganism Diphyllobothrium latum infection	Psychosis Insomnia Depression Cognitive slowing Restless leg syndrome	Neurological deficit Myelopathy Memory loss with reduced attention span Nystagmus Positive romberg sign Positive Lhermitte's sign	−	−	Anisochromic	Macrocytic	↑	↓	Nl	Nl	↑	↑	↓	↑	↑	Senile neutrophil Anisocytosis Ovalocytes
Orotic aciduria^[3]	Autosomal recessive Deficiency of enzyme UMPS	Episodic vomiting Rhabdomyolysis	Coma Gastrointestinal manifestation	Neurological manifestation	−	−	Anisochromic	Macrocytic	↑	↓	Nl	Nl	↑	↑	↓	↑	↑	NA
Fanconi anemia^[4]	Autosomal recessive X-linked recessive	History of anemia at age 16	Hypopigmentation Cafe-au-lait patches Radial ray anomaly	Significant for bilateral short thumbs	−	−	Anisochromic	Macrocytic	↑	↓	Nl	Nl	↑	↑	↓	↑	↑	Nl appearing WBC, RBC and Platelets But the number is greatly reduced
Disease	Genetics	History	Symptoms	Signs	Hemolysis	Intrinsic/Extrinsic	Hb concentration	MCV	RDW	Reticulocytosis	Haptoglobin levels	Hepcidin	Serum iron	Serum Tfr level	IBC	Ferritin	Transferrin saturation	Specific finding on blood smear
Diamond-Blackfan anemia^[5]	Mutations in: RPL5 RPL11 RPL35A RPS7 RPS10 RPS17 RPS19 RPS24 RPS26	Associated with myelodysplastic syndrome Increased risk of AML	Pale skin Sleepiness Heart murmurs	Triphalangeal thumbs Short stature Microcephaly Hypertelorism Ptosis Micrognathia	−	−	Anisochromic	Macrocytic	Nl	↓	Nl	Nl	↑	↑	↓	↑	↑	NA
Liver disease^[6]	−	Hepatitis Binge drinking Gall bladder disease	Jaundice Abdominal pain Itchy skin	Ascites Right upper quadrant pain Hepatomegaly Swelling in the legs Ankle swelling	−	−	Anisochromic	Macrocytic	↑	↑	Nl	Nl	↑	↑	↓	↑	↑	Round macrocytes Target macrocytes
Alcoholism^[7]	−	History of increased alcohol intake Folic acid deficiency	Memory impairment Nausea Sweating	Truncal obesity Asterixis Encephalopathy Spider angiomas Hematemesis Gynecomastia	−	−	Anisochromic	Macrocytic	↑	↑	Nl	Nl	↑	↑	↓	↑	↑	Oval macrocytes Hypersegmented neutrophils
Disease	Genetics	History	Symptoms	Signs	Hemolysis	Intrinsic/Extrinsic	Hb concentration	MCV	RDW	Reticulocytosis	Haptoglobin levels	Hepcidin	Serum iron	Serum Tfr level	IBC	Ferritin	Transferrin saturation	Specific finding on blood smear

References

↑ Koike H, Takahashi M, Ohyama K, Hashimoto R, Kawagashira Y, Iijima M, Katsuno M, Doi H, Tanaka F, Sobue G (March 2015). "Clinicopathologic features of folate-deficiency neuropathy". Neurology. 84 (10): 1026–33. doi:10.1212/WNL.0000000000001343. PMID 25663227.
↑ Hunt A, Harrington D, Robinson S (September 2014). "Vitamin B12 deficiency". BMJ. 349: g5226. PMID 25189324.
↑ Grohmann K, Lauffer H, Lauenstein P, Hoffmann GF, Seidlitz G (April 2015). "Hereditary orotic aciduria with epilepsy and without megaloblastic anemia". Neuropediatrics. 46 (2): 123–5. doi:10.1055/s-0035-1547341. PMID 25757096.
↑ Alter BP (2014). "Fanconi anemia and the development of leukemia". Best Pract Res Clin Haematol. 27 (3–4): 214–21. doi:10.1016/j.beha.2014.10.002. PMC 4254647. PMID 25455269.
↑ Vlachos A, Blanc L, Lipton JM (June 2014). "Diamond Blackfan anemia: a model for the translational approach to understanding human disease". Expert Rev Hematol. 7 (3): 359–72. doi:10.1586/17474086.2014.897923. PMID 24665981.
↑ Marks PW (July 2013). "Hematologic manifestations of liver disease". Semin. Hematol. 50 (3): 216–21. doi:10.1053/j.seminhematol.2013.06.003. PMID 23953338.
↑ Yokoyama A, Yokoyama T, Brooks PJ, Mizukami T, Matsui T, Kimura M, Matsushita S, Higuchi S, Maruyama K (May 2014). "Macrocytosis, macrocytic anemia, and genetic polymorphisms of alcohol dehydrogenase-1B and aldehyde dehydrogenase-2 in Japanese alcoholic men". Alcohol. Clin. Exp. Res. 38 (5): 1237–46. doi:10.1111/acer.12372. PMID 24588059.

[pmid25663227-1] Koike H, Takahashi M, Ohyama K, Hashimoto R, Kawagashira Y, Iijima M, Katsuno M, Doi H, Tanaka F, Sobue G (March 2015). "Clinicopathologic features of folate-deficiency neuropathy". Neurology. 84 (10): 1026–33. doi:10.1212/WNL.0000000000001343. PMID 25663227.

[pmid25189324-2] Hunt A, Harrington D, Robinson S (September 2014). "Vitamin B12 deficiency". BMJ. 349: g5226. PMID 25189324.

[pmid25757096-3] Grohmann K, Lauffer H, Lauenstein P, Hoffmann GF, Seidlitz G (April 2015). "Hereditary orotic aciduria with epilepsy and without megaloblastic anemia". Neuropediatrics. 46 (2): 123–5. doi:10.1055/s-0035-1547341. PMID 25757096.

[pmid25455269-4] Alter BP (2014). "Fanconi anemia and the development of leukemia". Best Pract Res Clin Haematol. 27 (3–4): 214–21. doi:10.1016/j.beha.2014.10.002. PMC 4254647. PMID 25455269.

[pmid24665981-5] Vlachos A, Blanc L, Lipton JM (June 2014). "Diamond Blackfan anemia: a model for the translational approach to understanding human disease". Expert Rev Hematol. 7 (3): 359–72. doi:10.1586/17474086.2014.897923. PMID 24665981.

[pmid23953338-6] Marks PW (July 2013). "Hematologic manifestations of liver disease". Semin. Hematol. 50 (3): 216–21. doi:10.1053/j.seminhematol.2013.06.003. PMID 23953338.

[pmid24588059-7] Yokoyama A, Yokoyama T, Brooks PJ, Mizukami T, Matsui T, Kimura M, Matsushita S, Higuchi S, Maruyama K (May 2014). "Macrocytosis, macrocytic anemia, and genetic polymorphisms of alcohol dehydrogenase-1B and aldehyde dehydrogenase-2 in Japanese alcoholic men". Alcohol. Clin. Exp. Res. 38 (5): 1237–46. doi:10.1111/acer.12372. PMID 24588059.

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@@ Line 1: / Line 1: @@
 __NOTOC__
-{{Macrocytic anemia}}
+[[Image:Home_logo1.png|right|250px|link=https://www.wikidoc.org/index.php/Macrocytic_anemia]]
+{{CMG}}; {{AE}} {{ADS}}
+==Overview==
+Megaloblastic anemia needs to be diffrentiated from other causes of anemia.
+==Differentiating Macrocytic Anemia from Other Diseases==
+'''''To review the differential diagnosis of anemia, click [[Anemia#Differentiating Anemia from Other Diseases|here]].'''''
+{|
+! rowspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Disease
+! rowspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Genetics
+! colspan="5" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Clinical manifestation
+! colspan="12" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Lab findings
+|-
+! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |History
+! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Symptoms
+! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Signs
+! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Hemolysis
+! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Intrinsic/Extrinsic
+! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Hb concentration
+! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |MCV
+! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |RDW
+! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Reticulocytosis
+! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Haptoglobin levels
+! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Hepcidin
+! colspan="5" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Iron studies
+! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Specific finding on blood smear
+|-
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Serum iron
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Serum Tfr level
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Transferrin or TIBC
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Ferritin
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" | Transferrin saturation
+|-
+! align="center" style="background:#DCDCDC;" |[[Folate deficiency]]<ref name="pmid25663227">{{cite journal |vauthors=Koike H, Takahashi M, Ohyama K, Hashimoto R, Kawagashira Y, Iijima M, Katsuno M, Doi H, Tanaka F, Sobue G |title=Clinicopathologic features of folate-deficiency neuropathy |journal=Neurology |volume=84 |issue=10 |pages=1026–33 |date=March 2015 |pmid=25663227 |doi=10.1212/WNL.0000000000001343 |url=}}</ref>
+| align="left" style="background:#F5F5F5;" |
+* Impaired [[DNA]] synthesis
+| align="left" style="background:#F5F5F5;" |
+* [[Long-term effects of alcohol|Alcohol consumption]]
+* History of using drugs like [[methotrexate]], [[trimethoprim]], and [[phenytoin]]
+* Low socioeconomic groups with poor nutrition
+* Older people
+* [[Pregnancy|Pregnant]] and [[lactating]] women
+| align="left" style="background:#F5F5F5;" |
+* No neurological symptoms vs [[Vitamin B12 deficiency|B12 deficiency]]
+* [[Odinophagia|Odynophagia]]
+* [[Stomatitis|Angular stomatitis]]
+| align="left" style="background:#F5F5F5;" |
+* [[Glossitis]]
+* Signs of [[Congestive heart failure|heart failure]]
+* [[Anencephaly]] and [[spina bifida]]
+| align="center" style="background:#F5F5F5;" |−
+| align="center" style="background:#F5F5F5;" |−
+| align="center" style="background:#F5F5F5;" |Anisochromic
+| align="center" style="background:#F5F5F5;" |[[Macrocytic anemia|Macrocytic]]
+| align="center" style="background:#F5F5F5;" |↑
+| align="center" style="background:#F5F5F5;" |↓
+| align="center" style="background:#F5F5F5;" |Nl
+| align="center" style="background:#F5F5F5;" |Nl
+| align="center" style="background:#F5F5F5;" |↑
+| align="center" style="background:#F5F5F5;" |↑
+| align="center" style="background:#F5F5F5;" |↓
+| align="center" style="background:#F5F5F5;" |↑
+| align="center" style="background:#F5F5F5;" |↑
+| align="left" style="background:#F5F5F5;" |
+* [[Macrocytosis|RBC macrocytosis]]
+* [[Neutrophil|Hypersegmented neutrophils]]
+* [[Pancytopenia]] in severe cases
+*
+|-
+! align="center" style="background:#DCDCDC;" |[[Vitamin B12 deficiency]]<ref name="pmid25189324">{{cite journal |vauthors=Hunt A, Harrington D, Robinson S |title=Vitamin B12 deficiency |journal=BMJ |volume=349 |issue= |pages=g5226 |date=September 2014 |pmid=25189324 |doi= |url=}}</ref>
+| align="left" style="background:#F5F5F5;" |
+* Impaired [[DNA synthesis]]
+| align="left" style="background:#F5F5F5;" |
+* [[Pernicious anemia]]
+* [[Crohn's disease]]
+* [[Gastrectomy]]
+* [[Vegan|Veganism]]
+* [[Diphyllobothrium|Diphyllobothrium latum]] infection
+| align="left" style="background:#F5F5F5;" |
+* [[Psychosis]]
+* [[Insomnia]]
+* [[Depression]]
+* Cognitive slowing
+* [[Restless leg syndrome]]
+| align="left" style="background:#F5F5F5;" |
+* Neurological deficit
+* [[Myelopathy]]
+* [[Memory loss]] with reduced attention span
+* [[Nystagmus]]
+* Positive [[Romberg test|romberg sign]]
+* Positive [[Lhermitte's sign]]
+| align="center" style="background:#F5F5F5;" |−
+| align="center" style="background:#F5F5F5;" |−
+| align="center" style="background:#F5F5F5;" |Anisochromic
+| align="center" style="background:#F5F5F5;" |[[Macrocytic anemia|Macrocytic]]
+| align="center" style="background:#F5F5F5;" |↑
+| align="center" style="background:#F5F5F5;" |↓
+| align="center" style="background:#F5F5F5;" |Nl
+| align="center" style="background:#F5F5F5;" |Nl
+| align="center" style="background:#F5F5F5;" |↑
+| align="center" style="background:#F5F5F5;" |↑
+| align="center" style="background:#F5F5F5;" |↓
+| align="center" style="background:#F5F5F5;" |↑
+| align="center" style="background:#F5F5F5;" |↑
+| align="left" style="background:#F5F5F5;" |
+* [[Senile]] [[neutrophil]]
+* [[Anisocytosis]]
+* [[Ovalocytosis|Ovalocytes]]
+|-
+! align="center" style="background:#DCDCDC;" |[[Orotic aciduria]]<ref name="pmid25757096">{{cite journal |vauthors=Grohmann K, Lauffer H, Lauenstein P, Hoffmann GF, Seidlitz G |title=Hereditary orotic aciduria with epilepsy and without megaloblastic anemia |journal=Neuropediatrics |volume=46 |issue=2 |pages=123–5 |date=April 2015 |pmid=25757096 |doi=10.1055/s-0035-1547341 |url=}}</ref>
+| align="left" style="background:#F5F5F5;" |
+* [[Autosomal recessive]]
+* Deficiency of enzyme [[Uridine monophosphate synthetase|UMPS]]
+| align="left" style="background:#F5F5F5;" |
+* Episodic [[Nausea and vomiting|vomiting]]
+* [[Rhabdomyolysis]]
+| align="left" style="background:#F5F5F5;" |
+* [[Coma]]
+* [[Gastrointestinal tract|Gastrointestinal]] manifestation
+| align="left" style="background:#F5F5F5;" |
+* Neurological manifestation
+| align="center" style="background:#F5F5F5;" |−
+| align="center" style="background:#F5F5F5;" |−
+| align="center" style="background:#F5F5F5;" |Anisochromic
+| align="center" style="background:#F5F5F5;" |[[Macrocytic anemia|Macrocytic]]
+| align="center" style="background:#F5F5F5;" |↑
+| align="center" style="background:#F5F5F5;" |↓
+| align="center" style="background:#F5F5F5;" |Nl
+| align="center" style="background:#F5F5F5;" |Nl
+| align="center" style="background:#F5F5F5;" |↑
+| align="center" style="background:#F5F5F5;" |↑
+| align="center" style="background:#F5F5F5;" |↓
+| align="center" style="background:#F5F5F5;" |↑
+| align="center" style="background:#F5F5F5;" |↑
+| align="center" style="background:#F5F5F5;" |NA
+|-
+! align="center" style="background:#DCDCDC;" |[[Fanconi anemia]]<ref name="pmid25455269">{{cite journal |vauthors=Alter BP |title=Fanconi anemia and the development of leukemia |journal=Best Pract Res Clin Haematol |volume=27 |issue=3-4 |pages=214–21 |date=2014 |pmid=25455269 |pmc=4254647 |doi=10.1016/j.beha.2014.10.002 |url=}}</ref>
+| align="left" style="background:#F5F5F5;" |
+* [[Autosomal recessive]]
+* [[X-linked recessive]]
+| align="left" style="background:#F5F5F5;" |
+* History of [[anemia]] at age 16
+| align="left" style="background:#F5F5F5;" |
+* [[Hypopigmentation]]
+* [[Café au lait spot|Cafe-au-lait patches]]
+* Radial ray anomaly
+| align="left" style="background:#F5F5F5;" |
+* Significant for bilateral short thumbs
+| align="center" style="background:#F5F5F5;" |−
+| align="center" style="background:#F5F5F5;" |−
+| align="center" style="background:#F5F5F5;" |Anisochromic
+| align="center" style="background:#F5F5F5;" |[[Macrocytic anemia|Macrocytic]]
+| align="center" style="background:#F5F5F5;" |↑
+| align="center" style="background:#F5F5F5;" |↓
+| align="center" style="background:#F5F5F5;" |Nl
+| align="center" style="background:#F5F5F5;" |Nl
+| align="center" style="background:#F5F5F5;" |↑
+| align="center" style="background:#F5F5F5;" |↑
+| align="center" style="background:#F5F5F5;" |↓
+| align="center" style="background:#F5F5F5;" |↑
+| align="center" style="background:#F5F5F5;" |↑
+| align="left" style="background:#F5F5F5;" |
+* Nl appearing [[White blood cells|WBC]], [[Red blood cell|RBC]] and [[Platelet|Platelets]]
+* But the number is greatly reduced
+|-
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Disease
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Genetics
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |History
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Symptoms
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Signs
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Hemolysis
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Intrinsic/Extrinsic
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Hb concentration
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |MCV
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |RDW
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Reticulocytosis
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Haptoglobin levels
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Hepcidin
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Serum iron
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Serum Tfr level
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |IBC
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Ferritin
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Transferrin saturation
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Specific finding on blood smear
+|-
+! align="center" style="background:#DCDCDC;" |[[Diamond-Blackfan anemia]]<ref name="pmid24665981">{{cite journal |vauthors=Vlachos A, Blanc L, Lipton JM |title=Diamond Blackfan anemia: a model for the translational approach to understanding human disease |journal=Expert Rev Hematol |volume=7 |issue=3 |pages=359–72 |date=June 2014 |pmid=24665981 |doi=10.1586/17474086.2014.897923 |url=}}</ref>
+| align="left" style="background:#F5F5F5;" |Mutations in:
+* ''RPL5''
+* ''RPL11''
+* ''RPL35A''
+* ''RPS7''
+* ''RPS10''
+* ''RPS17''
+* ''RPS19''
+* ''RPS24''
+* ''RPS26''
+| align="left" style="background:#F5F5F5;" |
+* Associated with [[myelodysplastic syndrome]]
+* Increased risk of [[AML]]
+| align="left" style="background:#F5F5F5;" |
+* [[Pale skin]]
+* Sleepiness
+* [[Murmur|Heart murmurs]]
+| align="left" style="background:#F5F5F5;" |
+* Triphalangeal  thumbs
+* [[Short stature]]
+* [[Microcephaly]]
+* [[Hypertelorism]]
+* [[Ptosis]]
+* [[Micrognathia]]
+| align="center" style="background:#F5F5F5;" |−
+| align="center" style="background:#F5F5F5;" |−
+| align="center" style="background:#F5F5F5;" |Anisochromic
+| align="center" style="background:#F5F5F5;" |[[Macrocytic anemia|Macrocytic]]
+| align="center" style="background:#F5F5F5;" |Nl
+| align="center" style="background:#F5F5F5;" |↓
+| align="center" style="background:#F5F5F5;" |Nl
+| align="center" style="background:#F5F5F5;" |Nl
+| align="center" style="background:#F5F5F5;" |↑
+| align="center" style="background:#F5F5F5;" |↑
+| align="center" style="background:#F5F5F5;" |↓
+| align="center" style="background:#F5F5F5;" |↑
+| align="center" style="background:#F5F5F5;" |↑
+| align="center" style="background:#F5F5F5;" |NA
+|-
+! align="center" style="background:#DCDCDC;" |[[Hepato-biliary diseases|Liver disease]]<ref name="pmid23953338">{{cite journal |vauthors=Marks PW |title=Hematologic manifestations of liver disease |journal=Semin. Hematol. |volume=50 |issue=3 |pages=216–21 |date=July 2013 |pmid=23953338 |doi=10.1053/j.seminhematol.2013.06.003 |url=}}</ref>
+| align="center" style="background:#F5F5F5;" |−
+| align="left" style="background:#F5F5F5;" |
+* [[Hepatitis]]
+* Binge drinking
+* Gall bladder disease
+| align="left" style="background:#F5F5F5;" |
+* [[Jaundice]]
+* [[Abdominal pain]]
+* [[Itchy skin]]
+| align="left" style="background:#F5F5F5;" |
+* [[Ascites]]
+* Right upper quadrant pain
+* [[Hepatomegaly]]
+* [[Edema|Swelling]] in the legs
+* [[Ankle swelling]]
+| align="center" style="background:#F5F5F5;" |−
+| align="center" style="background:#F5F5F5;" |−
+| align="center" style="background:#F5F5F5;" |Anisochromic
+| align="center" style="background:#F5F5F5;" |[[Macrocytic anemia|Macrocytic]]
+| align="center" style="background:#F5F5F5;" |↑
+| align="center" style="background:#F5F5F5;" |↑
+| align="center" style="background:#F5F5F5;" |Nl
+| align="center" style="background:#F5F5F5;" |Nl
+| align="center" style="background:#F5F5F5;" |↑
+| align="center" style="background:#F5F5F5;" |↑
+| align="center" style="background:#F5F5F5;" |↓
+| align="center" style="background:#F5F5F5;" |↑
+| align="center" style="background:#F5F5F5;" |↑
+| align="left" style="background:#F5F5F5;" |
+* [[Macrocyte|Round macrocytes]]
+* [[Macrocyte|Target macrocytes]]
+|-
+! align="center" style="background:#DCDCDC;" |[[Alcoholism]]<ref name="pmid24588059">{{cite journal |vauthors=Yokoyama A, Yokoyama T, Brooks PJ, Mizukami T, Matsui T, Kimura M, Matsushita S, Higuchi S, Maruyama K |title=Macrocytosis, macrocytic anemia, and genetic polymorphisms of alcohol dehydrogenase-1B and aldehyde dehydrogenase-2 in Japanese alcoholic men |journal=Alcohol. Clin. Exp. Res. |volume=38 |issue=5 |pages=1237–46 |date=May 2014 |pmid=24588059 |doi=10.1111/acer.12372 |url=}}</ref>
+| align="center" style="background:#F5F5F5;" |−
+| align="left" style="background:#F5F5F5;" |
+* History of increased [[Effects of alcohol on the body|alcohol intake]]
+* [[Folic acid deficiency]]
+| align="left" style="background:#F5F5F5;" |
+* [[Memory impairment]]
+* [[Nausea]]
+* [[Sweating]]
+| align="left" style="background:#F5F5F5;" |
+* Truncal [[obesity]]
+* [[Asterixis]]
+* [[Encephalopathy]]
+* [[Spider angiomas]]
+* [[Hematemesis]]
+* [[Gynecomastia]]
+| align="center" style="background:#F5F5F5;" |−
+| align="center" style="background:#F5F5F5;" |−
+| align="center" style="background:#F5F5F5;" |Anisochromic
+| align="center" style="background:#F5F5F5;" |[[Macrocytic anemia|Macrocytic]]
+| align="center" style="background:#F5F5F5;" |↑
+| align="center" style="background:#F5F5F5;" |↑
+| align="center" style="background:#F5F5F5;" |Nl
+| align="center" style="background:#F5F5F5;" |Nl
+| align="center" style="background:#F5F5F5;" |↑
+| align="center" style="background:#F5F5F5;" |↑
+| align="center" style="background:#F5F5F5;" |↓
+| align="center" style="background:#F5F5F5;" |↑
+| align="center" style="background:#F5F5F5;" |↑
+| align="left" style="background:#F5F5F5;" |
+* [[Macrocyte|Oval macrocytes]]
+* [[Neutrophil|Hypersegmented neutrophils]]
+|-
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Disease
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Genetics
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |History
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Symptoms
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Signs
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Hemolysis
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Intrinsic/Extrinsic
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Hb concentration
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |MCV
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |RDW
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Reticulocytosis
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Haptoglobin levels
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Hepcidin
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Serum iron
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Serum Tfr level
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |IBC
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Ferritin
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Transferrin saturation
+! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Specific finding on blood smear
+|}
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Macrocytic anemia differential diagnosis: Difference between revisions

Latest revision as of 20:56, 26 February 2019

Overview

Differentiating Macrocytic Anemia from Other Diseases

References

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