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Discussion Starter · #1 ·
When in a exam question you face a laboratory value of MCV>100
you think about macrocytosis, but what are differential diagnoses?

of course the first diagnoses are B12 or folate deficiency but don't forget the possibility of these diseases:

  • Liver disease
  • Hypothyroidism
  • Hemolysis (in most cases with normocytic anemia), actually any case of reticulocytosis bec retics are big :)
  • Myelodysplastic syndromes

Important point:
Oval cells in B12 and folate deficiency (ovalocytosis) and round cells in other diseases
 

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difference between macrocytosis and megaloblastosis

Remember that all the anemias with MCV> 100 are macrocytosis, but ONLY b21, folate and MTX give you megaloblastosis, with the peculiar sign of hypersegmente neutrophils
 
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