Macrocytic Anemia

Macrocytic Anemia is caused by a deficiency of vitamin B-12 with low red blood cell count, characterized by the presence in the blood of larger than normal erythrocytes (red blood cells), also developed in alcoholics. Macrocytosis is a term used to describe this cell condition. The amount of hemoglobin in the cell increases proportionately, so the mean cell hemoglobin concentration remains within normal limits. The causes of macrocytosis are diverse and range from benign to malignant.

Macrocytic Anemia may occur at any age, but its incidence is more prevalent in elderly groups because the causes of macrocytosis are more prevalent in older persons, but alcoholism can lead to this condition disregarding age, as well as congenital predisposal. Diagnosis of the etiology of macrocytosis is required before the morbidity and mortality can be determined.

Several rare hereditary anemia’s, including Macrocytic Anemia, are characterized by nuclear anomalies of the erythrocytes, such as karyorrhexis, macrocytosis or multinuclearity. Another of the most common type of the so-called HEMPAS is an autosomal recessive condition characterized by multinuclear erythrocytes and a positive acidified serum test.

Among the most common causes that lead the individual to develop a Macrocytic Anemia, is Megaloblastic Anemia the predominant. This condition is the result of impaired DNA synthesis and, although DNA synthesis is impaired, the RNA synthesis is unaffected, leading in such case to a buildup of cytoplasmic components in a slowly dividing cell, resulting in the larger-than-normal cell, with a nuclear chromatin also altered in appearance.

There is no evidence of complications and Macrocytic Anemia is directly attributable to the increased size of the red cell, although those complications when they occur are attributed to the condition causing the macrocytosis. Individuals with obstructive jaundice or hepatic disease have a macrocytosis that is secondary to increased cholesterol and phospholipids deposited on the membranes of circulating RBCs.

Macrocytic Anemia symptoms and signs are attributable to the underlying condition that caused the anemia or to the anemia itself, including dyspnea, headache, fatigue, sore tongue, diarrhea and other gastrointestinal symptoms. A clinical history of alcohol abuse may be an important clue in the diagnose and treatment because it used to be the cause of the increased mcv, the same as a thorough examination of the individual's medication regimen, crucial in the workup of macrocytosis.

Other physical signs include certain manifestations including glossitis, tachycardia, flow murmurs, splenomegaly, conjunctival pallor, and other neurological disorders such as ataxia, loss of deep tendon reflexes, particularly ankle reflex, loss of posterior column sensations, and confabulation. Since the cause that leads to Macrocytic Anemia is mainly vitamin b-12 deficiency, early diagnosis and prompt treatment to reestablish the normal vitamin levels and restore the body's retention are significant to limit the severity of the anemia and neurological complications.

Dietary deficiency of vitamin b-12 can result from the lack of intrinsic factor in individuals who have Pernicious Anemia (Megaloblastic Anemia) or with post-gastrectomy status, or mal-absorption of vitamin b-12 secondary to small bowel, as well as overgrowth, tapeworm, familial factors, drugs, ileal bypass, ileal enteritis, or sprue or inherited disorders of DNA.

Vitamin B12 is essential not only as a prevention to avoid the development of Macrocytic Anemia, but also as a part of normal nervous system functions and blood cell production. A well balance diet including the main sources of vitamin B12, such as eggs, meat, and dairy products, give to the organism the required amount absorbed by the body in healthy individuals. It must bind to intrinsic factor, a protein secreted by cells in the stomach. With mal-absorption condition the first signs appear in the form of paleness, shortness of breath, fatigue and weakness

Macrocytic Anemia also can be prevented with the use of vitamin B12 injections, especially after surgeries that also are an identified cause of vitamin B12 deficiency.

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