Clinico-haematological and biochemical evaluation of macrocytic anaemia: a prospective cross sectional study

Author: 
Niranjana Sakhare., Shailendra Jambhulkar., Nisha Meshram., Kumbhalkar D. T and Raut W. K

Introduction: Macrocytic anemia is not a specific disease but rather an indicator of diverse underlying diseases and demands further clinical and laboratory assessment. We went to evaluate the clinico-haematological and biochemical parameters of macrocytic anaemia in this study.
Materials and Methods: The study was cross-sectional conducted for 2 years on 99 patients of anaemia and macrocytosis. Macrocytic anaemia was identified on complete blood count (CBC) with haemoglobin (Hb) <10 g/dl and mean corpuscular volume (MCV) >100 fl and/or macrocytosis on peripheral smear. Bone marrow aspiration, reticulocyte count and serum vitamin B12, folic acid, serum lactate dehydrogenase (LDH), serum bilirubin, Aspartate aminotransferase (AST), Alanine aminotransferase (ALT) were evaluated.
Results: The most common cause of macrocytic anaemia was megaloblastic anaemia (97.9%) while 2 (2.02%) cases had non-megaloblastic macrocytosis. The megaloblastic anaemia was due to either vitamin B12 deficiency (56.6%) or folate deficiency (23.2%), while combined deficiency observed in 18.2% of cases. Among 97 patients of megaloblastic anaemia 74.2% cases showed MCV >100 fl and 43.3% cases had pancytopenia. 51.5% cases had very high serum LDH levels >3000 U/L.
Conclusions: Vitamin B12 deficiency was most common cause of macrocytic anaemia, in vegetarians followed by folic acid and combined deficiency of folate and vitamin B12. Estimation of vitamin B12, folic acid and LDH levels were sufficient to diagnose megaloblastic anaemia.

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DOI: 
DOI: http://dx.doi.org/10.24327/ijcar.2017.5556.0749
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