In this measurement, technologists failed to identify microcytes 33 percent of the time, and failed to identify
macrocytes 24 percent of the time.
thalassemia major results in
macrocytes rather than microcytes.
RBCs with abnormal shapes (e.g., spherocytes or elliptocytes) or sizes (e.g., microcytes or
macrocytes) may not remain active in the bloodstream for the full 120 days, but may become sequestered and destroyed earlier.
Since both may have presence of
macrocytes, peripheral smear examination alone may pose a difficulty in distinction between the two in the absence of macro-ovalocytes and hypersegmented neutrophils, in these cases bone marrow examination is useful.
Patients with Peripheral smear showing predominant
macrocytes, hypersegmented neutrophils, and clinical features suspected of megaloblastic anemia; like knuckle pigmentation, early graying of hair, dyspepsia, bald tongue along with anemia, proven B12 deficiency biochemically and bone marrow proven megaloblastic anemia were included in the study.
Presence of megaloblastic anaemia can usually be suspected from examination of peripheral blood with oval
macrocytes being characteristic but examination of bone marrow aspirate is crucial in the diagnoses.
Macrocytosis is a relatively common finding in the era of automated blood cell counters with 1.7% - 3.6%
macrocytes being seen.
The most common features in blood smears were: polychromatophils,
macrocytes, nucleated red blood cells, teardrop cells, hypogranulation and hypo/hypersegmentation in leukocytes and giant platelets.
Email: hoy@actrix.gen.nz Parameter Initial Reference Haematology result interval Haemoglobin 106 130-175 g/L RBC 3.8 4.0-6.0 x[10.sup.12]/L Haematocrit 0.33 0.37-0.50 MCV 85 80-99 fL MCH 28 27-34 pg Platelets 405 160-400 x[10.sup.9]/L WBC 5.1 4.0-11.0 x[10.sup.9]/L Neutrophils 3.9 2.0-7.0 x[10.sup.9]/L Lymphocytes 0.8 1.0-4.0 x[10.sup.9]/L Monocytes 0.3 0.2-1.0 x[10.sup.9]/L Eosinophils 0.1 0.0-0.7 x[10.sup.9]/L ESR 27 1-30 mm/Hr A few
macrocytes and target cells.
Hematology screening tests included hematocrit, hemoglobin,
macrocytes, and percentage reticulocytes.
Peripheral smear showed anisopoikilocytosis with normocytes,
macrocytes, microcytes, ovalocytes, occasional spherocytes; normochromic and mildly hypochromic RBCs, increase in Rouleaux formation; severe leucopenia; neutrophils and lymphocytes almost equal with occasional monocytes; platelet count reduced and reported as pancytopenia.