Based on the blood film, we can distinguish between megaloblastic types and non-megaloblastic types. A megaloblast is an unusually large erythroblast that has delayed nuclear maturation
Causes of macrocytic, megaloblastic anaemia include: Vitamin B12 deficiency, folate deficiency, and cytotoxic drugs
B12 and folate deficiency result in similar blood film appearances. Thus, to distringuish between them we need to run serum B12 and serum folate (or red cell folate).
Causes of macrocytic, non-megaloblastic anaemia include alcohol (most common cause), liver disease, hypothyroidism, reticulocytosis, pregnancy and haematological malignancies such as myelodysplasia, myeloma, and aplastic anaemia.
Run LFTs, TFTs, and if necessary, a bone marrow trephine to establish the cause.
Causes of macrocytic, megaloblastic anaemia include: Vitamin B12 deficiency, folate deficiency, and cytotoxic drugs
B12 and folate deficiency result in similar blood film appearances. Thus, to distringuish between them we need to run serum B12 and serum folate (or red cell folate).
Causes of macrocytic, non-megaloblastic anaemia include alcohol (most common cause), liver disease, hypothyroidism, reticulocytosis, pregnancy and haematological malignancies such as myelodysplasia, myeloma, and aplastic anaemia.
Run LFTs, TFTs, and if necessary, a bone marrow trephine to establish the cause.