Macrocytic Anemias Hematology Review 310
HEMOGLOBIN
ANEMIA ETIOLOGY BLOOD SMEAR ELECTROPHORESIS OTHER
Megaloblastic
Folate deficiency
Vitamin B 12
deficiency
Nonmegaloblastic
Nutritional deficiency, ↑cell
replication (e.g., hemolytic
anemias, myeloproliferative dis-
eases, pregnancy), malabsorp-
tion, drug inhibition. Deficiency
impairs DNA synthesis.
Nutritional deficiency, malab-
sorption, impaired utilization,
parasites. Deficiency impairs
DNA synthesis.
Alcoholism, liver disease,
↑erythropoiesis.
Oval macrocytes,
Howell-Jolly bodies,
hypersegmentation,
aniso, poik
Same
Round macrocytes, no
hypersegmentation
Normal
Normal
Normal
Pancytopenia, ↑LD
Same. Pernicious anemia
is most common type.
Autoimmune disease.
Gastric atrophy leads to
↓intrinsic factor needed
for B 12 absorption
WBC & PLT normal
