NORMAN HELMAN, M.D.
To the editor: McPhedran and co-workers report, in "Interpretation of Electronically Determined Macrocytosis" in the May 1973 issue (pp. 677-683), that people with an elevated mean corpuscular volume of 115 μm3 or greater and a normal hemoglobin concentration usually have folic acid deficiency, vitamin B12 deficiency, or liver disease, or any combination of these. I would like to report another cause of macrocytosis: cigarette smoking.
I am studying the Model S Coulter Counter results in 1000 patients undergoing routine physical examination. I hope to publish these data when the statistical analysis is completed. All patients had normal hemoglobin concentrations. Of
HELMAN N. Macrocytosis and Cigarette Smoking. Ann Intern Med. ;79:287–288. doi: 10.7326/0003-4819-79-2-287_2
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Published: Ann Intern Med. 1973;79(2):287-288.
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