Choice and assessment of clinical laboratory parameters in megloblastic anemias.
Anemia
- Normocytic, normochromic – MCV, MCH in ref ranges
- Hypocytic, hypochromic – ↓MCV, ↓MCH, Fe deficiency, thalassemia’s
- Macrocytic - ↑MCV, ↑MCH
- Megablastic – B12 and folic acid deficiency
Size (microcytic/normocytic/macrocytic) Hb (hypochromic/normochromic/hyperchromic) Anaemia also may be classified by red cell morphology as macrocytic, normocytic, or microcytic, an approach that is useful in differential diagnosis.
- MCV – microcytic anemia (< 75 fl)
- MCV – macrocytic anemia (>105 fl)
Normal ranges
- Haemoglobin: m140-180, f: 120-160 g/L
- Hematocrit: m: 0.4-0.54, f: 0.36-0.47 l/L
- Erythrocytes m: 4.5-6.0, f: 3.9- 5.4 T/L
- MCV (volume of 1 RBC) 82-96 fl
- MCH (content of haemoglobin in 1RBC) 27-33 pg
- MCHC (content of haemoglobin in all RBC)300-360 g/L
Basic analyses: CBC (Hb, Erys number, Hct, MCV, MCH, MCHC, RDW, Thr, WBC); screening coagulation tests (PT, APTT, FBG, TT), urine, morphology of RBC (peripheral blood smear), Ret
RBC's -120 days but they die due early
Inherited thalassemia (MCV ↓) CBC + blood smear; Sickle cell CBC + blood smear
Anemia also may be classified by red cell morphology as macrocytic, normocytic, or microcytic, an approach that is useful in differential diagnosis. MCV – microcytic anemia (<75 fl) MCV – macrocytic anemia (>105 fl)
Reticulocytosis; ↑ Indirect bilirubin - Hemolytic jaundice; ↑ Urobilinogen in urine; ↑LDH; haptoglobulin ↓; ↑ Fe; ↓TIBC - transferrin
The erythrocytes are macrocytic, and, with respect to bone marrow cells, with a mean cell diameter greater than 8 μm and a cell volume (MCV) usually greater than 100fl. Mean cell Hb content (MCH) is more than 36 pg and thus indicates hyperchromic anemia. Almost all patients with hyperchromic anemia suffer from vitamin B12 and/or folic acid deficiency.
Megaloblastic anaemia: Megaloblastic anemia is a blood disorder marked by the appearance of very large red blood cells. Anemia is a blood disorder that results in the loss of red blood cells. Red blood cells transport oxygen through the body; without adequate amounts, tissues and organs suffer a lack of oxygen. Diagnosing Megaloblastic Anemia This kind of anemia is usually found during routine blood tests. These can include a complete blood count (CBC) and a red blood cell folate level check. Your doctor will also gather your medical history and perform a physical exam. This is to rule out other causes of your symptoms.