Macrocytic normoblastic anaemia
Macrocytosis (large circulating red blood cells) are seen with normal erythrocyte progenitor cells in the bone marrow (normoblasts).
Macrocytic normoblastic anaemia may be physiological (in pregnancy and in neonates), pathological, e.g. alcohol, liver disease, hypothyroidism or drug induced, e.g. azathioprine. The exact mechanism is not understood, but there is often an increased lipid deposition in the membrane of the red cells.
Symptoms and signs of anaemia.
Full blood count shows anaemia with large cells (raised MCV). Serum vitamin B12 and red cell folate are normal. Thyroid function tests and liver function tests (including γ GT) should be performed.
Any underlying cause should be treated where appropriate.