Medical history (history of illness) represents an important component in the diagnosis of macrocytosis. Family history Is there a family history of blood disorders? Social anamnesis Current medical history/systemic history (somatic and psychological complaints). Have you noticed symptoms such as a general decrease in performance, dizziness, or palpitations? Have you noticed gastroenterological symptoms such as … Macrocytosis: Medical History
Respiratory System (J00-J99) Chronic obstructive pulmonary disease (COPD) – pulmonary disease in which there is progressive (progressive) airway obstruction (narrowing) that is not fully reversible (reversible). Blood, blood-forming organs – immune system (D50-D90). Acute or chronic blood loss → reticulocytosis (immature erythrocytes/red blood cells), e.g., due to genetic hematologic disorders (sickle cell disease, hereditary spherocytosis, … Macrocytosis: Or something else? Differential Diagnosis
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; further: Inspection (viewing): skin, mucous membranes, and sclerae (white part of the eye) [jaundice (yellowing of the skin)?, smooth red tongue?, cheilosis (redness and swelling of the lips)?, glossitis (inflammation of the … Macrocytosis: Examination
1st order laboratory parameters – obligatory laboratory tests. Small blood count [macrocytic hyperchromic anemia: MCV ↑ → macrocyticMCH ↑ → hyperchromic] Differential blood count Inflammatory parameters – ESR (erythrocyte sedimentation rate) or CRP (C-reactive protein). Urine status (rapid test for: pH, leukocytes, nitrite, protein, glucose, ketone, urobilinogen, bilirubin, blood), sediment, if necessary urine culture (pathogen … Macrocytosis: Test and Diagnosis
Optional medical device diagnostics – depending on the results of the history, physical examination, laboratory diagnostics, and obligatory medical device diagnostics – for differential diagnostic clarification. Abdominal ultrasonography (ultrasound examination of abdominal organs) – to exclude renal/liver diseases, changes in the gastrointestinal tract (gastrointestinal tract). Esophago-gastro-duodenoscopy (ÖGD; reflection of esophagus, stomach and duodenum) with biopsy … Macrocytosis: Diagnostic Tests
The following symptoms and complaints may occur together with macrocytosis: Leading symptom Macrocytosis = occurrence of abnormally large erythrocytes (= macrocytes) whose mean corpuscular volume (MCV) is increased to more than 98 (100) femtoliters (fl) compared with normal. Associated symptoms Occurrence depending on the underlying disease (see below differential diagnoses).
