Macrocytic anemia is defined as macrocytosis (mean corpuscular volume (MCV) greater than 100 fL).
Macrocytosis affects 2% to 4% of the population, 60% of whom are anemic.
The cause of macrocytic anemia is classified into one of the following categories, megaloblastic or non-megaloblastic.
The most common cause is alcohol use, which is followed by folate, vitamin B12 deficiency, and medication use.
Neurologic symptoms and mood disturbances are common complaints among vitamin B12 deficiency patients.
Folate deficiency has common features except for neuropsychiatric complaints.
Patients suffering from chronic megaloblastic anemia caused by vitamin B12 deficiency may develop permanent neurologic damage known as subacute combined neurodegeneration.
Initial assessment of macrocytic anemia involves a thorough history and physical examination, followed by a few lab tests (PBS, reticulocyte count, and serum B12).
Macrocytic anemia can be treated by replacing folate or vitamin B12 and targeting the underlying cause.
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