by. Ana Sirley Calderon Flores. on 11 November Comments (0). Please log in to add your comment. Report abuse. Transcript of ANEMIA MACROCITICA. Megaloblastosis can be associated with severe anemia and pancytopenia, gastrointestinal dysfunction and glossitis, personality changes. Macrocytosis without anemia may be a normal variant and is only noted as a result of repeated peripheral RBC indices in the absence of any known or existing.
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This abnormality is usually recognized by the automated blood cell counter and confirmed on review of the peripheral blood smear. Blackwell Scientific Publishers; During treatment, further monitoring of the complete blood cell count or measuring vitamin B12 and folate levels or their metabolites is not necessary.
Megaloblastic Anemia and Other Causes of Macrocytosis
It is imperative that a hematologist or hematopathologist examine macrocitiva marrow in order to appreciate these important, subtle, hematopoietic abnormalities. In these instances the peripheral blood smear may show a mixed population of microcytic and macrocytic RBCs with an elevated distribution width.
This time-honored method remains an acceptable form of treatment for all causes of vitamin B12 deficiency, particularly when cognitive impairment or neurologic disease is present. Investigation of Vitamin B12 and Folate Deficiencies Macrocytosis is the earliest abnormality seen in complete blood counts of patients with folate or vitamin B12 deficiency. By using this site, you agree to the Terms of Use and Privacy Policy. Cobalamin and folate are cofactors in several important metabolic pathways maacrocitica the cell.
En su estadio final estas lesiones son, por supuesto, irreversibles. Blood chemistries will also show:. Acta Med Scand ; Until one is identified, it is recommended that when initial vitamin B12 values are low i. Folic acid deficiency in the United States is extremely rare because of the fortification of foods.
Retrieved 21 June Fanconi anemia Diamond—Blackfan anemia Acquired: In which subject field? For determination of cause, further patient history, testing, and empirical therapy may be clinically indicated.
Megaloblastic anemia – Wikipedia
Similar morphologic abnormalities can be seen in the other myeloid elements, e. Pitiriasis Rosada de Gibert. Megaloblastic anemia is a blood disorder in which there is anemia with larger-than-normal red blood cells.
Patients with macrocytosis who are not anemic and have no other abnormalities noted on the peripheral blood smear do not usually need a bone marrow macroocitica. Its serum concentration can be used to measure the amount of vitamin B12 attached to the binding protein transcobalamin II. Determining the underlying cause of the macrocytosis can be particularly challenging when thalassemia trait or iron deficiency or other nutritional deficiencies coexist with a vitamin B12 or folate deficiency.
En la tabla 2 se resumen la principales causas. The evaluation of the patient with macrocytosis requires a systemic approach.
Erroneous values on the Model S Coulter Counter due to high titer cold autoagglutinins. Unsourced or poorly sourced material may be challenged and removed.
Megaloblastic Anemia and Other Causes of Macrocytosis
A Marked macro-ovalocytosis MCV fl in the peripheral blood smear of a patient with vitamin B12 deficiency. Additionally, a careful review of the peripheral blood smear noting the morphology of the RBCs, as well as the other cellular elements and features on the smear, can provide important clues as to the etiology of the anemia. More severe degrees of abnormal proliferation and maturation are seen with myelodysplasia and myeloid leukemias. Bone Marrow Examination Macrocytosis associated with a megaloblastic marrow is usually accompanied by anemia due to ineffective erythropoiesis.
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Harrison’s Principles of Internal Medicine 18th ed. Serum MMA will be elevated in patients with underlying renal dysfunction, decreasing its specificity and sensitivity in identifying patients with cobalamin deficiency. Existen tres picos de mayor prevalencia: Arch Intern Med ; In some instances this variation from normal can be found in other family members, which suggests a genetic predisposition, and requires no therapeutic intervention or further investigation.
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