Medical expert of the article
New publications
Red blood cell macrocytosis.
Last reviewed: 07.06.2024
![Fact-checked](/sites/default/files/fact-checked.png)
All iLive content is medically reviewed or fact checked to ensure as much factual accuracy as possible.
We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies. Note that the numbers in parentheses ([1], [2], etc.) are clickable links to these studies.
If you feel that any of our content is inaccurate, out-of-date, or otherwise questionable, please select it and press Ctrl + Enter.
![](https://iliveok.com/sites/default/files/styles/term_image/public/gallery/makrocitoz.jpg?itok=Jhf-OK9D)
Macrocytosis is a medical term that describes a condition in which the level of red blood cells, known as red blood cells, is higher than normal and they have an increased size. This can be determined using the mean red blood cell volume (MCV), which is measured in femtoliters (fL).
Causes of the macrocytosis
Here are some of the most common causes of macrocytosis:
- Vitamin B12 (cobalamin) or folic acid deficiency: These vitamins are essential for the normal formation of DNA inside red blood cells. A deficiency of B12 or folic acid can lead to abnormal red blood cell development and consequently macrocytosis.
- Alcohol abuse: Excessive alcohol consumption can affect the formation of red blood cells and cause macrocytosis.
- Chronic liver disease: Liver disease, such as cirrhosis or alcoholic hepatitis, can affect red blood cell formation and function.
- Hemolytic anemia: This is a group of anemias in which red blood cells are destroyed faster than they are made. This can cause macrocytosis.
- Hypothyroidism (low thyroid function): Lack of thyroid hormones can affect red blood cell formation and cause macrocytosis.
- Myelodysplastic syndromes: This is a group of rare hematopoietic disorders that can lead to macrocytosis.
- Medications: Some medications, such as cytostatics and anticonvulsants, can cause macrocytosis as a side effect.
- Genetic factors: Rare inherited disorders can lead to macrocytosis.
It is important to note that macrocytosis can be a sign of other medical conditions, so when it is detected, it is important to see a doctor for additional tests and to determine the cause. Treatment of macrocytosis will depend on the underlying cause.
Symptoms of the macrocytosis
Macrocytosis by itself may not always show symptoms, especially if it is mild and not accompanied by other blood disorders. However, in advanced cases of macrocytosis or when it is combined with other conditions, the following signs and symptoms may occur:
- Weakness and fatigue: Enlarged red blood cells may be less efficient at carrying oxygen, which can cause feelings of weakness and fatigue.
- Pallor of skin and mucous membranes: Macrocytosis may be accompanied by anemia, which may lead to pallor of skin and mucous membranes.
- Shortness of breath: Lack of oxygen in the body due to enlarged but less functional red blood cells can cause shortness of breath.
- Dizziness and headaches: Lack of oxygen can also cause dizziness and headaches.
- Signs of an underlying condition: If macrocytosis is caused by another medical condition, symptoms of that condition may occur. For example, if macrocytosis is associated with vitamin B12 deficiency, symptoms associated with that deficiency, such as numbness and problems with motor coordination, may occur.
- Symptoms of underlying liver disease: If macrocytosis is associated with liver disease, there may be symptoms associated with this condition, such as jaundice and abdominal pain.
- Other symptoms: Depending on the underlying cause of the macrocytosis and the presence of other comorbidities, other symptoms may appear.
Diagnostics of the macrocytosis
Diagnosing macrocytosis begins with a physical examination and laboratory tests to determine the level and size of red blood cells (red blood cells) in the blood. Here are some of the basic steps that may be included in the diagnostic process:
- Clinical Examination: The physician performs a general physical examination and talks to the patient about their medical and family history and the presence of symptoms associated with macrocytosis.
- Blood test: The main diagnostic method is the blood test. This test can be used to determine hemoglobin levels, hematocrit, and other blood parameters, including mean red blood cell volume (MCV). If the MCV is higher than normal (usually more than 100 fL), it may indicate macrocytosis.
- Additional tests: Additional laboratory tests may be needed to determine the cause of macrocytosis. For example, measuring levels of vitamin B12 and folic acid may help determine if macrocytosis is related to a deficiency of these vitamins. Other tests, such as peripheral blood tests, may also be performed to evaluate the shape and structure of red blood cells.
- Additional Diagnosis: Depending on the findings and clinical symptoms, other diagnostic modalities such as educational tomography (CT) or ultrasound may be required to rule out or confirm the presence of an underlying disease.
- Evaluation of the underlying disease: If macrocytosis is caused by another medical condition, it is important to further evaluate and treat that condition.
Diagnosis includes both laboratory tests and clinical evaluation to establish the cause and determine appropriate treatment. Once a diagnosis is made, the physician develops a treatment plan, which may include correction of vitamin deficiencies, treatment of the underlying disease, or other medical measures depending on the specific circumstances.
Who to contact?
Treatment of the macrocytosis
Treatment of macrocytosis depends directly on its underlying cause. Because macrocytosis is a symptom and not a disease in its own right, successful treatment involves identifying and correcting the underlying medical condition or factor causing the increased size of red blood cells (red blood cells). Here are some of the possible approaches to treating macrocytosis:
- Vitamin replacement: If macrocytosis is caused by a deficiency of vitamin B12 or folic acid, treatment may involve replacing these vitamins. This can be accomplished through taking special medications or changing the diet.
- Treatment of the underlying disease: If macrocytosis is a consequence of another medical condition such as chronic liver disease, hypothyroidism, or hemolytic anemia, treatment should be aimed at correcting that underlying condition.
- Medication changes: If macrocytosis is associated with taking certain medications, the doctor may consider changing the drug therapy or dosage.
- Blood transfusions: In some cases, especially in severe forms of macrocytosis, periodic blood transfusions may be required to improve hemoglobin levels and relieve symptoms.
- Additional measures: Symptomatic measures such as oxygen therapy may be used to manage symptoms of macrocytosis, such as dyspnea or dizziness.
It is important to note that successful treatment depends on determining its underlying cause and the individual characteristics of the patient.
Forecast
The prognosis of macrocytosis depends on its underlying cause and how successfully it can be controlled or treated. In most cases, macrocytosis can be successfully controlled or treated, especially if its cause is related to vitamin B12 or folic acid deficiency, which can be corrected with diet and/or medication.
However, it is important to note that macrocytosis can be a sign of other more serious medical conditions such as hemolytic anemia, liver disease, hypothyroidism, or myelodysplastic syndromes. In such cases, the prognosis will depend on the characteristics and severity of the underlying disease.
If macrocytosis is caused by other conditions, successful management or treatment of these conditions can help improve prognosis and prevent further complications. It is important to get a consultation with your doctor and follow his or her recommendations for treatment and care.
The prognosis may also depend on individual patient factors such as age, general health and the presence of other comorbidities. Therefore, a comprehensive examination and consultation with a physician is necessary for a more accurate prognosis.