| Abstrakt: |
Introduction: Macrocytic anaemia refers to macrocytosis (mean corpuscular volume (MCV) greater than 100 fL). Macrocytosis needs to be evaluated even in the absence of anaemia, as it may be the first clue to an underlying clinicalor haematological disease. It can be wrongly diagnosed as iron deficiency anaemia in many situations. It is one of the preventable and treatable causes of anaemia. Evaluation of its clinical, haematological and etiological profile and assessment of the relation of red cell indices with macrocytic anaemia can provide early diagnosis and timely initiation of treatment. Material and methods: After obtaining institutional ethical committee clearance, a hospital based longitudinal study was done in 154 adult patients (written informed consent taken) diagnosed with macrocytic anaemia (MCV >100fl) during the study period (september 2020-may 2023). Convenient sampling method was used. Data on socio-demography, history and clinical examination were recorded. Relevantlaboratoryinvestigations which included peripheral smear and bone marrow biopsy was done. Patients were managed accordingly. Results: Males and females were 83 (53.9%) and 71(46.1%) respectively. The mean (SD) age of study participants being 51.92(19.5) years. Majority of the patients had easy fatigability (77.3%), followed by dyspnoea (64.9%). Range of haemoglobin, MCV, MCH, MCHC and PCV was 3.5-14g/dl, 100-172 fL, 26-49 pg, 22-42 g/dl and 5%-35% respectively. Bone marrow biopsy was done in 58 patients. Hypocellular marrow was the most common finding seen in 23(14.9%) patients. Megaloblastic erythroid hyperplasia was found in 9(5.8%). Megaloblastic anaemia was seen in 34 patients (56.7%). Non-megaloblastic anaemia was seen in 26 patients (39.7%). Megaloblastic anaemia and non megaloblastic anaemia was seen in 88 (57.1%) and 61(39.6%) patients respectively. Conclusions: Megaloblastic anaemia and non megaloblastic anaemia was seen in 88 (57.1%) and 61(39.6%) patients respectively. Non megaloblastic causes included haemolytic anaemia (10/6.5%), primary bone marrow disorders in (46/29.9%) and miscellaneous (5/3.2%). Causes of megaloblastic anaemia included, 63 (40.9%)with B1 + B12deficiency + folate deficiency, 12(7.8%) with B12+folatedeficiency (11.7%), 13(8.4%) with B12 + other causes. [ABSTRACT FROM AUTHOR] |
