Macrocytic normoblastic anaemia - Macrocytic anaemia

Macrocytic anaemia

Macrocytic normoblastic anaemia

Definition

Macrocytosis (large circulating red blood cells) are seen with normal erythrocyte progenitor cells in the bone marrow (normoblasts).

Aetiology/pathophysiology

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.

Clinical features

Symptoms and signs of anaemia.

Investigations

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.

Management

Any underlying cause should be treated where appropriate.