Macrocytosis as a Consequence of Alcohol Abuse among Patients in General Practice

Abstract

Macrocytosis, a common finding in patients without anemia or other hematologic abnormalities, is often ignored. The purpose of this prospective study was to investigate 300 consecutive, adult health-center patients with a mean cell volume (MCV) value greater than or equal to 100 fl. The incidence of macrocytosis was 2.4%. Of the 177 male and 123 female patients, only 14 (4.7%) were anemic; 80.2% of the men (89.3% of those under 60 years) and 34.1% of the women were alcohol abusers, representing the largest diagnostic group. The highest MCV value found in alcoholics without folate or vitamin B12 deficiency was 120 fl. The most useful laboratory test for identifying alcohol abuse among macrocytic patients was the measurement of serum gamma-glutamyltransferase. Of the several morphologic abnormalities in the marrow the only specific finding were vacuoles in the granulocyte or erythrocyte precursors. No underlying cause was found for macrocytosis in 6.8% of the men and 35.8% of the women. Even when it is not associated with anemia, macrocytosis should not be ignored. It may be the only indicator of a disease which often, particularly in young and middle-aged men, is alcohol abuse.

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

“…Although 37 patients (34 %) were daily alcohol drinkers, the authors argued that alcoholism alone is not sufficient to raise MCV above 130 fL. This was consistent with our data and those of previous reports: Seppä et al reported that the highest MCV value found in alcoholics without folate or vitamin B12 deficiency was 120 fL [22], and Veda reported that the maximum MCV observed in alcoholism was 114 fL [16]. Regarding the effect of medications, in our series as in previous reports, one patient treated with HU showed an MCV of 130.2 fL, and one patient among those seen at the eight other hospitals showed an MCV of 133.5 fL.…”

Hematological Profile of Alcohol Dependent subjects: Report from a Tertiary Care Treatment Centre in India

“…MCV has long been used as part of the screening procedure for detecting alcohol abuse 11 . An elevation of MCV in AD patients may be caused by a deficiency of folate or vitamin B12 or as a direct result of exposure to ethanol per se or its metabolite (i.e., acetaldehyde).The significantly higher value of MCV in AD patients compared to healthy controls seen in this study is in agreement with previous studies [12][13] .The association of MCV with amount of alcohol consumed indicates a dose dependent pattern. Thus heavy chronic users may report a higher MCV levels as compared to moderate users.…”

Blood markers of alcohol use in epistaxis patients

“…However, looking at macrocytosis in the studied population, 24 patients (4.7%) revealed pathologic values of [100 fl. Comparing these with the cumulative macrocytosis values from literature (480/ 16,488; 2.9%) consisting of 1.7% [11], 2.4% [12], 3.0% [7], 3.7% (cut off 98.5 fl) [13] we observed a significantly higher incidence (p = 0.03). Twelve of the 24 patients (50%) had a bleeding source located posteriorly and (Fig.…”