From the Guidelines
The patient's blood test results indicate macrocytosis, as evidenced by an elevated MCV of 101 fL, suggesting potential vitamin B12 or folate deficiency, liver disease, alcoholism, or certain medications as underlying causes, and further testing is recommended to determine the specific cause. The blood test results show mostly normal values with a few abnormalities. The white blood cell count (WBC) is 4.0 x10E3/uL, which is within the normal range of 3.4-10.8 x10E3/uL, as reported in the study 1. The red blood cell count (RBC) is 4.07 x10E6/uL, which is also within the normal range of 3.77-5.28 x10E6/uL. Similarly, the hemoglobin level is 13.2 g/dL, which falls within the normal range of 11.1-15.9 g/dL. The hematocrit is 41.2%, which is within the normal range of 34.0-46.6%. However, the MCV (mean corpuscular volume) is elevated at 101 fL, which is above the normal range of 79-97 fL, as described in the study 1. According to the study, an MCV greater than 100 fL is indicative of macrocytosis, which can be caused by vitamin B12 or folate deficiency, liver disease, alcoholism, or certain medications. The MCH (mean corpuscular hemoglobin) is 32.4 pg, which is slightly above the normal range of 26.6-33.0 pg, and the MCHC (mean corpuscular hemoglobin concentration) is 32.0 g/dL, which is within the normal range of 31.5-35.7 g/dL. The RDW (red cell distribution width) is 11.5%, though the normal range is not provided. Given the elevated MCV, further testing for vitamin B12 and folate levels would be recommended to determine the specific cause of the macrocytosis, as suggested in the study 1. A clinical correlation with the patient's medical history, medication use, and alcohol consumption would also be important for proper diagnosis and management.
From the Research
Laboratory Results
- WBC: 4.0 x10E3/uL (normal range: 3.4-10.8)
- RBC: 4.07 x10E6/uL (normal range: 3.77-5.28)
- Hemoglobin: 13.2 g/dL (normal range: 11.1-15.9)
- Hematocrit: 41.2% (normal range: 34.0-46.6)
- MCV: 101 fL (normal range: 79-97)
- MCH: 32.4 pg (normal range: 26.6-33.0)
- MCHC: 32.0 g/dL (normal range: 31.5-35.7)
- RDW: 11.5% (low)
Possible Causes of Macrocytosis
- The patient's MCV is 101 fL, which is above the normal range, indicating macrocytosis 2, 3, 4, 5.
- Possible causes of macrocytosis include:
Further Evaluation
- A peripheral smear should be performed to differentiate between megaloblastic and non-megaloblastic anemia 2, 3, 4, 5.
- Vitamin B12 and folate levels should be checked to rule out deficiency 2, 3, 4, 5.
- Reticulocyte count and thyroid and liver function tests may also be helpful in determining the underlying cause of macrocytosis 2, 3, 4, 5.