JOSEPH A. LIBNOCH, M.D.
To the editor: The demonstration by McPhedran and colleagues (1) that half of all patients with significant macrocytosis have a deficiency of vitamin B12 or folate, or both, indicates the importance of scrutinizing the erythrocyte indexes recorded by the Coulter Counter, even when there are reasonably satisfactory hemoglobin levels. But the assignment by the authors of another quarter of their 100 patients to the categories of macrocytosis with liver disease and alcoholism tends to perpetuate the concept that macrocytosis with liver disease is a distinct etiologic entity. The thin macrocyte of liver disease seems to be a legitimate entity,
LIBNOCH JA. Macrocytosis. Ann Intern Med. ;79:456–458. doi: 10.7326/0003-4819-79-3-456
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Published: Ann Intern Med. 1973;79(3):456-458.
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