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Interpretation of Electronically Determined Macrocytosis

PETER McPHEDRAN, M.D.; MARSHALL G. BARNES, M.D.; JACK S. WEINSTEIN, M.D.; and JAMES S. ROBERTSON, B.S.
[+] Article and Author Information

Grant support: 5T01GM00696 and HE 05316-12, U.S. Public Health Service.

Presented in part 19 April 1972, 53rd Annual Session, American College of Physicians, Atlantic City, New Jersey.

▸Requests for reprints should be addressed to Peter McPhedran, M.D., Yale-New Haven Hospital, 789 Howard Ave., Room 142 MU, New Haven, CT 06504.


New Haven, Connecticut


Ann Intern Med. 1973;78(5):677-683. doi:10.7326/0003-4819-78-5-677
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Macrocytosis identified by electronic erythrocyte sizing equipment is clinically significant whether anemia is present or not. Half of all patients with marked macrocytosis (mean corpuscular volume of 115 µm3 or greater) identified in a hospital hematology laboratory had deficiency of folic acid or vitamin B12, or both, as defined by erythrocyte folate and plasma B12 measurements. The proportion of deficient patients increased with increasing degrees of macrocytosis. Of patients without deficiency, half had liver disease or alcoholism with probable liver disease. Screening patients with marked macrocytosis for deficiency of folic acid and vitamin B12 has a high diagnostic yield and has become a routine procedure in our laboratory.

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macrocytosis

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