Abstract
Macrocytosis is most commonly associated with vitamin B12 and folic acid deficiency, followed by alcoholism, liver disease, and other pathologic
conditions. We studied the red cell and vitamin status in 423 consecutive patients
with various liver diseases, including 31 with acute viral hepatitis (AVH), 105 with
chronic hepatitis (CH), and 134 with alcoholic liver disease (ALD), who consisted
of 84 with non-cirrhotic alcoholic liver disease (NCALD) and 50 with alcoholic liver
cirrhosis (ALC), 60 with non-alcoholic liver cirrhosis (NALC), and 93 with hepatocellular
carcinoma (HCC). The mean corpuscular volume (MCV) and red cell distribution width
(RDW) were significantly higher in patients with ALD and NALC, and among them macrocytosis
occurred more frequently in patients with ALC. Macrocytic anemia was mostly found
in cirrhotic patients, in which the Child-Pugh score was closely related to the development
of macrocytic anemia. In ALD, the MCV was significantly correlated with the estimated
alcohol consumption and inversely correlated with the serum folic acid level, which,
however, was often maintained within the normal range in patients with macrocytic
ALC. After abstinence from alcohol, the MCV and RDW were reduced significantly and
were associated with an increasing serum folic acid level. This suggests that macrocytic
anemia was a common feature of alcoholic and non-alcoholic liver cirrhosis and that
alcohol abuse and folic acid deficiency play a secondary role in macrocytosis. (J
Lab Clin Med 2001;138:332-7)
Abbreviations:
ALC (alcoholic liver cirrhosis), ALD (alcoholic liver disease), AVH (acute viral hepatitis), CH (chronic hepatitis), Hb (hemoglobin), HBV (hepatitis B virus), HCC (hepatocellular carcinoma), Hct (hematocrit), HCV (hepatitis C virus), MCH (mean corpuscular hemoglobin), MCHC (mean corpuscular hemoglobin concentration), MCV (mean corpuscular volume), NALC (non-alcoholic liver cirrhosis), NCALD (non-cirrhotic alcoholic liver disease), RBC (red blood cell), RDW (red cell distribution width)To read this article in full you will need to make a payment
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Article Info
Publication History
Accepted:
August 1,
2001
Received in revised form:
May 29,
2001
Received:
March 22,
2001
Footnotes
☆Reprint requests: Shigeo Maruyama, MD, Department of Internal Medicine, Saiseikai Gotsu General Hospital, Gotsu-city, 695, Shimane, Japan.
Identification
Copyright
© 2001 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
