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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). | '''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). | ||
==Treatment== | |||
* Folate is administered 1mg QD. Higher doses may be required in malabsorptive syndromes. It is empirically given to those with SCD and those on HD. | |||
* B12 must be given as a load then maintenance. Most advocate 1000 mcg IM Qweek x4 then 100mcg/month. | |||
* LDH falls in 2 days. Hypokalemia requiring replacement can occur in the acute phase as new cells are being generated rapidly. | |||
* A reticulocytosis begins in 3-5 days and peaks in 10 days. The HCT will rise within 10days. If it does not, suspect another disorder. Hypersegmented PMNs disappear in 10-14 days. | |||
* Neurologic abnormalities may take up to 6 months to resolve if ever. The longer the disease has been present, the worse is the prognosis for recovery. | |||
* Persons with PA have a 2x risk of gastric CA (in some studies). Screen for occult blood. | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
Revision as of 14:47, 21 September 2012
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Macrocytosis is the enlargement of red blood cells 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).
Treatment
- Folate is administered 1mg QD. Higher doses may be required in malabsorptive syndromes. It is empirically given to those with SCD and those on HD.
- B12 must be given as a load then maintenance. Most advocate 1000 mcg IM Qweek x4 then 100mcg/month.
- LDH falls in 2 days. Hypokalemia requiring replacement can occur in the acute phase as new cells are being generated rapidly.
- A reticulocytosis begins in 3-5 days and peaks in 10 days. The HCT will rise within 10days. If it does not, suspect another disorder. Hypersegmented PMNs disappear in 10-14 days.
- Neurologic abnormalities may take up to 6 months to resolve if ever. The longer the disease has been present, the worse is the prognosis for recovery.
- Persons with PA have a 2x risk of gastric CA (in some studies). Screen for occult blood.
References
gl:Anemia megaloblástica he:אנמיה מגלובלסטית it:Anemia megaloblastica sl:Megaloblastna anemija sr:Мегалобластна анемија