Abstract

The term macrocytosis describes the presence of macrocytes on a blood film, together with a raised mean corpuscular volume (MCV>100 fl). It is a common finding in the complete blood count(CBC) and may or may not be associated with anaemia. The aim of the study was to identify the underlying cause of macrocytosis and to analyze the haematological features of macrocytosis in routine complete blood count(CBC) and peripheral blood smear in different etiopathological factors. This study was carried out in 140 adult patients whose complete blood count and peripheral smear examination, serum vitamin B12 assay, folic acid assay, thyroid, liver and kidney function tests were done along with detailed medical history. In this study group, alcoholism (39.3%) was found to be the common causative factor of macrocytosis, followed by Vitamin B12 deficiency (27.6%) and medication(11.7%). In 26 patients, underlying cause of macrocytosis could not be ruled out. Anaemia was present in 70 cases (58.3%), being most common in Vitamin B12 deficiency. Hypersegmented neutrophils and macro-ovalocytes in peripheral blood film were found predominantly in megaloblastic disease. Macrocytosis needs to be evaluated even in the absence of anemia, as it may be the first clue to an underlying pathology. A detail evaluation of routine complete blood count (CBC) and peripheral blood smear greatly helps in identifying the underlying etiology for macrocytosis.