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La Rivista Italiana della Medicina di Laboratorio 2019 Giugno;15(2):104-19

DOI: 10.23736/S1825-859X.19.00012-4

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: Italian

Modern morphology nowadays as the first diagnostic step in approaching macrocytosis study

Barbara CASOLARI ¹ ✉, Anna M. CENCI ²

¹ U.O.S. Qualità e Accreditamento, Area Programmazione e Governo Attività Sanitarie AUSL Modena, Modena, Italia; ² Gruppo di Studio in Ematologia SIPMeL, Commissione Formazione Permanente SIPMeL, Castelfranco Veneto, Treviso, Italia

Macrocytosis is a condition where the mean erythrocyte volume (MCV) of circulating red blood cells (GR) is increased (>100 fL) compared to the commonly used reference values (fL 80-95). The incidence in the general population (2-4%) is low and it may be an accidental discovery in patients with no symptoms or associated to other clinical symptoms. Macrocytosis can appear in several pathologies with different etiology, ranging from paraphysiologic conditions such as pregnancy, to the results of the action on erythropoiesis of some antineoplastic drugs, toxic substances (alcohol), B-vitamin group deficiency. Macrocytosis is also one of the main features and classification hinges (Macrocytic Anemias Group) of several types of anemia (pernicious, sideroblastic,megaloblastic anemia, aplastic anemia, myelodysplasia-linked anemia). The discovery of macrocytosis is always important, and it can be essential in particular life ages, as in the old age, often being the first sign of an outbreak of serious pathologies. Nowadays macrocytosis can be found with a particularly easy tool as the GR-related CBC data, MCV firstly, and by the study of microscopic morphology, enriched by automatically provided information about all the circulating blood-cell clusters. In macrocytosis, these data are the basis of the first study approaches, sometimes crucial in case of unclear or otherwise difficult diagnosis. These data are still essential for the definition and start of appropriate diagnostic flow chart, even in times of more sophisticated laboratory tests.

KEY WORDS: Erythrocyte indices; Blood cells Count; Macrocytosis, familial