Macrocytosis: Or something else? Differential Diagnosis

Respiratory System (J00-J99)

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, glucose-6-phosphate dehydrogenase deficiency (G6PD deficiency; X-linked)).
  • Megaloblastic anemia (pernicious anemia) – anemia (anemia) caused by vitamin B12 deficiency or, less commonly, folic acid deficiency.
  • Runners anemia – anemia (anemia) due to an increase in blood plasma volume and increased hemolysis (dissolution of red blood cells) in runners.

Endocrine, nutritional and metabolic diseases (E00-E90).

Infectious and parasitic diseases (A00-B99).

Liver, gallbladder and bile ducts – Pancreas (pancreas) (K70-K77; K80-K87).

Mouth, esophagus (food pipe), stomach, and intestines (K00-K67; K90-K93).

Neoplasms – tumor diseases (C00-D48)

  • Myelodysplastic syndrome (MDS) – acquired clonal disease of the bone marrow associated with a disorder of hematopoiesis (blood formation); defined by:
    • Dysplastic cells in the bone marrow or ring sideroblasts or an increase of myeloblasts up to 19%.
    • Cytopenias (decrease in the number of cells in the blood) in the peripheral blood count.
    • Exclusion of reactive causes of these cytopenias.

    One quarter of MDS patients develop acute myeloid leukemia (AML).

  • Myeloproliferative disorders – group of malignant (malignant) hematological diseases (disease of the blood) that arise from monoclonal proliferation of a stem cell in the bone marrow (myeloid stem cell).

Psyche – nervous system (F00-F99; G00-G99).

  • Alcohol dependence (alcohol abuse)

Medication

  • 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.

Operations