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Causes of macrocytic anemia among 628 patients: mean corpuscular volumes of 114 and 130 fL as critical markers for categorization.

Abstract

There have been no studies on the distribution of causes of macrocytic anemia with respect to mean corpuscular volume (MCV) cutoff values. We retrospectively investigated the causes of macrocytic anemia (MCV ≥100 fL) among 628 patients who visited the outpatient hematology clinic in Tohoku University Hospital. To ensure data validity, we also analyzed data from 307 patients in eight other hospitals in the Tohoku district. The leading causes of macrocytic anemia (number of patients, %) were myelodysplastic syndromes (121, 19.3 %), suspected bone marrow failure syndromes (BMF; 74, 11.8 %), aplastic anemia (51, 8.1 %), plasma cell dyscrasia (45, 7.2 %), and vitamin B12 deficiency (40, 6.4 %) in Tohoku University Hospital. We made three primary findings as follows. First, the most common cause of macrocytic anemia is BMF. Second, lymphoid and solid malignancies are also common causes of macrocytosis. Third, macrocytic anemia may be classified into three groups: Group 1 (megaloblastic anemia and medications), which can exceed MCV 130 fL; Group 2 (alcoholism/liver disease, BMF, myeloid malignancy, and hemolytic anemia), which can exceed MCV 114 fL; and Group 3 (lymphoid malignancy, chronic renal failure, hypothyroidism, and solid tumors), which does not exceed MCV 114 fL. These conclusions were supported by the results from eight other hospitals.

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  • Authors+Show Affiliations

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    Department of Hematology and Rheumatology, Tohoku University Graduate School of Medicine, 1-1, Seiryo-cho, Aoba-ku, Sendai, 980-8574, Japan.

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    Department of Hematology and Rheumatology, Tohoku University Graduate School of Medicine, 1-1, Seiryo-cho, Aoba-ku, Sendai, 980-8574, Japan. j-kame@med.tohoku.ac.jp.

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    Department of Hematology, Nephrology, and Rheumatology, Akita University Graduate School of Medicine, Akita, Japan.

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    Department of Gastroenterology and Hematology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.

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    Department of Hematology/Oncology, Internal Medicine, Iwate Medical University, Morioka, Japan. Department of Hematology, Iwate Prefectural Central Hospital, Morioka, Japan.

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    Department of Hematology, Yamagata Prefectural Central Hospital, Yamagata, Japan.

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    Department of Cardiology and Hematology, Fukushima Medical University, Fukushima, Japan.

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    Department of Hematology, Sendai Medical Center, Sendai, Japan.

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    Department of Hematology, Miyagi Cancer Center, Natori, Japan.

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    Department of Neurology, Hematology, Metabolism, Endocrinology, and Diabetology, Faculty of Medicine, Yamagata University, Yamagata, Japan.

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    Department of Neurology, Hematology, Metabolism, Endocrinology, and Diabetology, Faculty of Medicine, Yamagata University, Yamagata, Japan.

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    Department of Hematology/Oncology, Internal Medicine, Iwate Medical University, Morioka, Japan.

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    Department of Hematology/Oncology, Internal Medicine, Iwate Medical University, Morioka, Japan.

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    Department of Hematology, Nephrology, and Rheumatology, Akita University Graduate School of Medicine, Akita, Japan.

    Department of Hematology and Rheumatology, Tohoku University Graduate School of Medicine, 1-1, Seiryo-cho, Aoba-ku, Sendai, 980-8574, Japan.

    Source

    International journal of hematology 104:3 2016 Sep pg 344-57

    MeSH

    Anemia, Aplastic
    Anemia, Macrocytic
    Anemia, Megaloblastic
    Bone Marrow Diseases
    Erythrocyte Indices
    Hemoglobinuria, Paroxysmal
    Humans
    Neoplasms
    Retrospective Studies

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    27352093

    Citation

    Takahashi, Natsuko, et al. "Causes of Macrocytic Anemia Among 628 Patients: Mean Corpuscular Volumes of 114 and 130 fL as Critical Markers for Categorization." International Journal of Hematology, vol. 104, no. 3, 2016, pp. 344-57.
    Takahashi N, Kameoka J, Takahashi N, et al. Causes of macrocytic anemia among 628 patients: mean corpuscular volumes of 114 and 130 fL as critical markers for categorization. Int J Hematol. 2016;104(3):344-57.
    Takahashi, N., Kameoka, J., Takahashi, N., Tamai, Y., Murai, K., Honma, R., ... Harigae, H. (2016). Causes of macrocytic anemia among 628 patients: mean corpuscular volumes of 114 and 130 fL as critical markers for categorization. International Journal of Hematology, 104(3), pp. 344-57. doi:10.1007/s12185-016-2043-x.
    Takahashi N, et al. Causes of Macrocytic Anemia Among 628 Patients: Mean Corpuscular Volumes of 114 and 130 fL as Critical Markers for Categorization. Int J Hematol. 2016;104(3):344-57. PubMed PMID: 27352093.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Causes of macrocytic anemia among 628 patients: mean corpuscular volumes of 114 and 130 fL as critical markers for categorization. AU - Takahashi,Natsuko, AU - Kameoka,Junichi, AU - Takahashi,Naoto, AU - Tamai,Yoshiko, AU - Murai,Kazunori, AU - Honma,Riko, AU - Noji,Hideyoshi, AU - Yokoyama,Hisayuki, AU - Tomiya,Yasuo, AU - Kato,Yuichi, AU - Ishizawa,Kenichi, AU - Ito,Shigeki, AU - Ishida,Yoji, AU - Sawada,Kenichi, AU - Harigae,Hideo, Y1 - 2016/06/28/ PY - 2016/03/01/received PY - 2016/06/16/accepted PY - 2016/06/15/revised PY - 2016/6/29/entrez PY - 2016/6/29/pubmed PY - 2017/3/17/medline KW - Bone marrow failure syndromes KW - MCV KW - Macrocytic anemia KW - Megaloblastic anemia KW - Solid tumors SP - 344 EP - 57 JF - International journal of hematology JO - Int. J. Hematol. VL - 104 IS - 3 N2 - There have been no studies on the distribution of causes of macrocytic anemia with respect to mean corpuscular volume (MCV) cutoff values. We retrospectively investigated the causes of macrocytic anemia (MCV ≥100 fL) among 628 patients who visited the outpatient hematology clinic in Tohoku University Hospital. To ensure data validity, we also analyzed data from 307 patients in eight other hospitals in the Tohoku district. The leading causes of macrocytic anemia (number of patients, %) were myelodysplastic syndromes (121, 19.3 %), suspected bone marrow failure syndromes (BMF; 74, 11.8 %), aplastic anemia (51, 8.1 %), plasma cell dyscrasia (45, 7.2 %), and vitamin B12 deficiency (40, 6.4 %) in Tohoku University Hospital. We made three primary findings as follows. First, the most common cause of macrocytic anemia is BMF. Second, lymphoid and solid malignancies are also common causes of macrocytosis. Third, macrocytic anemia may be classified into three groups: Group 1 (megaloblastic anemia and medications), which can exceed MCV 130 fL; Group 2 (alcoholism/liver disease, BMF, myeloid malignancy, and hemolytic anemia), which can exceed MCV 114 fL; and Group 3 (lymphoid malignancy, chronic renal failure, hypothyroidism, and solid tumors), which does not exceed MCV 114 fL. These conclusions were supported by the results from eight other hospitals. SN - 1865-3774 UR - https://www.unboundmedicine.com/medline/citation/27352093/Causes_of_macrocytic_anemia_among_628_patients:_mean_corpuscular_volumes_of_114_and_130 fL_as_critical_markers_for_categorization_ L2 - https://dx.doi.org/10.1007/s12185-016-2043-x DB - PRIME DP - Unbound Medicine ER -