Details
Category: Volume 11 Issue 07 July 2023
Hits: 390

Title: To Study Hematological Features in Various Etiologies of Macrocytic Anemias

Authors: Mamatha G, Dr Shreelaxmi V Hegde, Dr Chethan Sagar, Dr Satheesha B C, Tintu Mathew

 DOI: https://dx.doi.org/10.18535/jmscr/v11i7.05

Abstract

Background: Mean corpuscular volume (MCV) increases by more than 100 fl. in macrocytosis, a condition in which erythrocytes are larger than normal. The purpose of this study was to evaluate the haematological characteristics in various aetiologies and to determine the underlying reasons of macrocytosis, which was found in regular hemograms. In addition to doing full blood counts, renal function tests, liver function tests, vitamin B12 assays, folate assays, and peripheral smear evaluations and few case were bone marrow examination.

Material and Methods: In this prospective observational study conducted over a period of one-year, medical records of 250 subjects were evaluated. Data was compiled of Megaloblastic, Non-megaloblastic Macrocytosis levels, along with clinical diagnosis and other biochemical parameters. Based on clinical evaluation and hematological and biochemeical evidence, patients were diagnosed as positive cases of Megaloblastic(166), Non-Megaloblastic (133).Among this two variable group Mean ±SD were also calculated .

Results: Compared to other age groups, male (83%) of 41-50 years (p <0.01) were significantly affected as compared to female (16.4%) in similar age group. Our results showed , Vitamin B12 and Folic acid  (156.47 ± 125.28, 3.24±4.61 respectively) for Megaloblastic and that for Non- megaloblatic was (400.24±66.35, 18.25±6.37 respectively).Categorical variables of Megaloblastic with Non-megaloblastic macrocytosis was tested using Independent samples t test, that showed a significant elevated (p≤0.01).among this Non megaloblastic macrocytes foused And analyzed the other parameters like Complete blood count, Peripheral smear and Biochemical parameters like RFT, LFT, were statistically distributed and calculated the Mean±SD .

Conclusion: Alcoholism, inadequate vitamin B12 intake, and drug use are the main causes of macrocytosis. Even if anaemia is not present, an elevated MCV needs to be examined because it can be the solitary sign of a pathological problem underneath.

Keywords: Macrocytosis: megaloblastic, Non-megaloblastic, Vitamin B12, Folic acid, LFT, RFT, Peripheral smear.

References

  1. Aslinia F, Mazza JJ, Yale SH (2006) Megaloblastic anemia and other causes of Clin Med Res 4(3):236–241
  2. Hoffbrand V, Provan D (1997) ABC of clinical haematology Macrocytic BMJ 314(8):430–433
  3. Kaferle J, Strzoda CE (2009) Evaluation of macrocytosis. Am Fam Physician 79(3):203–208
  4. Thong KL, Hanley SA, Mcbride JA (1977) Clinical significance of a high mean corpuscular volume in nonanemic patients. CMA J 117:908–910
  5. Seppa¨ K, Heinila¨ K, Sillanaukee P, Saarni M (1996) Evaluation of macrocytosis by general J Stud Alcohol 57:97–100
  6. Wallerstein RO Jr (1987) Laboratory evaluation of anemia. West J Med 146:443–451
  7. Davidson RJ, Hamilton PJ (1978) High mean red cell volume: its incidence and significance in routine haematology. J Clin Pathol 31:493–498
  8. Mason KD, Szer J (2005) Investigating patients with macrocy- Med Today 6(12):35–39
  9. Bradley KA (1992) Screening and diagnosis of alcoholism in the primary care West J Med 156(2):166–171
  10. Conigrave KM, Haber P, Whitfield JB (2003) Traditional markers of excessive alcohol use. Society for the study of addiction to alcohol and other drugs, Addiction 98(Suppl 2):31–43
  11. de Benoist B (2008) Conclusions of a WHO Technical Consul- tation on folate and Vitamin B12 deficiencies. Food Nutr Bull 29(2):S238–S244
  12. Lee GR, Foerster J, Lukens J, Paraskevas F, Greer JP, Rodgers GM (1998) Wintrobe’s clinical hematology. Williams and Wil- kins, Baltimore
  13. Gore BP, Kurundkar G, Bhat SS. Retrospective Study of Serum LDH in Megaloblastic Anemia. Medical Science. 2015; 1:2249-555Savage DG, Ogundipe A, Allen RH, Stabler SP, Lindenbaum J (2000) Etiology and diagnostic evaluation of macrocytosis. Am J Med Sci 319(6):343–352
  14. Kamoun P. Transcobalamin II deficiency. 2003
  15. Iqbal SP, Kakepoto GN, Iqbal SP. Vitamin B12 deficiency-a major cause of megaloblastic anemia in patients attending a tertiary care hospital. J Ayub Med Coll. 2009; 21:92-94
  16. Rathee M, Tamrakar AK. Oral Health and Vitamin B12: A Review. Journal of Dental Sciences. 2013; 3:38-41
  17. Harold S, Ballard M.D. The Hematological Complications of Alcoholism. Alcohol health & research world. 1997; 1:142-52
  18. Kaferle J, Strzoda CE. Evaluation of Macrocytosis. American Family Physician. 2009; 3:204-208.
  19. Khanduri U, Sharma A (2007) Megaloblastic anaemia: preva- lence and causative Nat Med J India 20:172–175
  20. Park IK, Kim KY (1987) Clinical evaluation of red cell volume distribution width (RDW). Yonsei Med J 28(4):282–290
  21. Seppa¨ K, Sillanaukee P, Saarni M (1993) Blood count and hematologic morphology in nonanemic macrocytosis: differences between alcohol abuse and pernicious Alcohol 10(5):343–347
  22. Bessman JD, Gilmer PR Jr, Gardner FH (1983) Improved clas- sification of anemias by MCV and Am J Clin Pathol 80(3):322–326
  23. Bingham J. The macrocytosis of hepatic disease, thick macrocytosis. Blood, J Hematol. 1960, 244-254 5.
  24. Joseph AS, Cinkotai KI, Hunt L, Geary CG (1982) Natural his- tory of smouldering Br J Cancer 46:160
  25. Carmel R (2008) Mean corpuscular volume and other concerns in the study of vitamin B-12 deficiency: epidemiology with patho- Am J Clin Nutr 87:1962–1963
  26. Gupta PK, Saxena R, Karan AS, Choudhry VP (2003) Red cell indices for distinguishing macrocytosis of aplastic anaemia and megaloblastic Indian J Pathol Microbiol 46(3):375–377
  27. Butensky E, Harmatz P, Lubin M. Nutritional Anemias. 2008, 701-710. 2. Robert C, and Holt NS. How do you evaluate macrocytosis without anemia? The journal of family practice. 2008; 8:548-550.
  28. Aslinia F, Mazza JJ, Macp A, Yale SH. Megaloblastic Anemia and Other Causes of Macrocytosis. Clin Med Res. 2006, 4:236-241.
  29. Bingham J. The macrocytosis of hepatic disease, thick macrocytosis. Blood, J Hematol. 1960, 244-254 5.
  30. Ahmed T, Rahman AS, Ahmed S, Siddiqui A, Javed A, Kamal J et al. Frequency of Vitamin B12 and Red Cell Folate Deficiency in Macrocytic Anemia. Journal of Basic & Applied Sciences, 2012; 8:706-713.
  31. Braden CD. Spur Cell Anemia. Medscape, 2015.

Corresponding Author

Mamatha G

PhD-Research Scholar, Department of Biochemistry, Srinivas Institute of Allied Health Sciences, Mukka, Manglore-575025, Karnataka, India