Macrocytosis: pitfalls in testing and summary of guidance.

[Argirios Argiriou]

Summary points:

Macrocytosis is commonly associated with the use of several drugs and does not require further investigation unless there are additional clinical features.

Before testing, the probability of vitamin-B12 or folate deficiency should be undertaken by assessing relevant features in the history and examination.

Myelodysplastic syndromes often present as a macrocytic anaemia with normal vitamin-B12 and folate concentrations.

When full blood count is normal, vitamin-B12 deficiency should be suspected in patients with neurological signs and severe oropharyngeal ulceration.


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