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Macrocytosis: pitfalls in testing and summary of guidance.
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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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