Analysis of macrocytosis in a tertiary care hospital of North India

Introduction: ‘Macrocytosis' is the term used to describe large erythrocytes with increased mean corpuscular volume (MCV) seen in peripheral blood smears. Various pathological disorders with differentiating clinical, biochemical, hematological and bone marrow findings can attribute to macrocytosis. Aims and Objectives: We conducted a one year study, from Sep 2016 to Sep 2017 with the aim to identify the number and causes of macrocytosis and also to assess the haematological features associated with macrocytosis in peripheral blood smear and routine haemogram. We also evaluated the clinical, biochemical (Vitamin B12 and folate assay) and bone marrow studies to differentiate megaloblastic from nonmegaloblastic causes of macrocytosis. Results: Among 56 cases of macrocytosis received in a year, Megaloblastic anemia was the commonest etiological factor, followed by alcoholism and drug intake. Isolated macrocytosis without anaemia was noted in 4 cases. Presence of hypersegmented neutrophils and macro- ovalocytes was the most frequent observation in peripheral smear examination in all megaloblastic conditions. Conclusions: A meticulous interpretation of routine haemogram along with peripheral blood smear and biochemical analysis helps in identifying the underlying cause and treatment for macrocytosis.