Macrocytosis

Emmanuel C. Besa, MD

Thomas Jefferson University, Jefferson Medical College, Philadelphia, PA

Copyright of the American Society of Hematology, 2006. ISSN: 1931-6860.

III. LABORATORY DATA

The patient gives you the results of her most recent CBC, shown below.

CBC:
  Patient Results Normal Values (range)
  Hb
Hct
MCV
MCH
RDW
WBC 		12.6 g/dl
37%
105 fL
35.8 pg
14.9 SD
6.2 x 103/mm3 		(12-15.6)
(35-46)
(80-100)
(27-33)
(9-15)
(4.8-10.8)
Differential:
  Patient Results Normal Values (range)
  Neutrophils
Lymphocytes
Monocytes
Eosinophils
Basophils 		59%
30%
8%
3%
1% 		(42-75)
(20-51)
(5-10)
(0-7)
(0-7)
Platelets 312,000/mm3 (150-400,000)

Which laboratory tests should be ordered? Consider each of the following and click on the laboratory studies you believe will most help you make a diagnosis.

Bone Marrow Examination
Chemistries
Ferritin
Liver Function Tests
Methyl Malonic Acid (MMA) and Serum Homocysteine
Peripheral Blood Smear
Reticulocyte Count
Schilling’s test
Serum folate/Red Blood Cell (RBC) folate
Serum Vitamin B12

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