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 burning of the tongue, loss of appetite, or diarrhea?
- Have you noticed symptoms affecting the nervous system, such as sensory disturbances, muscle weakness, or forgetfulness?
Vegetative anamnesis including nutritional anamnesis.
- Do you eat a balanced and varied diet?
- Do you eat meat and meat products regularly?
- Do you drink alcohol? If so, what drink(s) and how many glasses per day?
- Do you use drugs? If yes, what drugs and how often per day or per week?
Self history incl. medication history.
- Pre-existing conditions (blood disorders, lung disease, liver disease, infections).
- Surgery (splenectomy)
- Allergies
- Pregnancies
Medication history
- Antiepileptic drugs
- Drugs that can cause folic acid deficiency: Methotrexate, 5-fluorouracil, hydroxyurea, trimethoprim/sulfamethoxazole, phenytoin.
- Drugs that interfere with absorption of folic acid: Metformin, cholestyramine
- See also under “Hematoxic drugs” if applicable.
