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Macrocytic anemia is a type of anemia characterized by the association between low levels of hemoglobin and abnormally large red blood cells (macrocytes) in the bloodstream. In this article, we explain the Causes of macrocytic anemia, its symptoms, diagnosis and possible treatment.
◉ What is Macrocytic Anemia?
Macrocytic anemia is known as one of the most important types of anemia, in which, in addition to the decrease in the amount of hemoglobin, there is an increase in the size of the red blood cells compared to their size normal.
- Anemia: hemoglobin levels below normal values according to age and sex.
- Macrocytic: when the Mean Corpuscular Volume (MCV) is above physiological values according to age and sex (>100fL in adults).
This condition often results from a deficiency in one of the important nutrients needed for the synthesis of red blood cells by the bone marrow, specifically, vitamin B12 and folic acid. These vitamins are essential for the production of healthy red blood cells that can carry oxygen.
◉ Types of Macrocytic Anemia
There are two types of macrocytic anemia, each of which is associated with specific causes and different biological factors than the other. These types include megaloblastic anemia and non-megaloblastic anemia.
1. Megaloblastic macrocytic anemia
It is a macrocytic anemia characterized by the presence of giant erythroblasts, called Megaloblasts, in the bone marrow. In the vast majority of cases it is linked to a deficiency in antipernicious factors (vitamin B12 and folic acid (vitamin B9)) but it can also be of toxic or neoplastic origin.
Both of these vitamins are essential for DNA synthesis, cell division in the bone marrow, and the production of healthy and fully functional red blood cells.
Blood cells grow larger due to their inability to produce enough DNA to divide at the proper time. This leads to an enlargement of the cells, which grow excessively before their usual division.
2. Non-megaloblastic macrocytic anemia
Non-megaloblastic macrocytic anemia is a type of macrocytic anemia (MCV > 100 fL but generally < 110 fL) that is not caused by a nuclear maturation defect.
◉ Causes of macrocytic anemia
◉ Causes of megaloblastic macrocytic anemia
The causes of megaloblastic macrocytic anemia are often related to deficiencies in vitamin B12 or folate, which can be attributed to various factors:
1- Decreased intake can occur when individuals have a low dietary intake of vitamin B12 (obtained from certain animal-based foods) or folate (found in leafy green vegetables and fruits). This condition can be caused by:
- Malnutrition or
- Excessive alcohol consumption.
2- Increased consumption: Certain medical conditions or circumstances can lead to increased consumption of yhese nutriments:
- During pregnancy
- Hemolysis
3- Malabsorption issues can interfere with the absorption of vitamin B12 or folate from the gastrointestinal tract:
- Pernicious anemia
- Intestinal disorders
- Gastrointestinal surgeries (gastric bypass, ileal resection)
- Certain medications (proton pump inhibitors (PPIs) and metformin)
- Zollinger-Ellison syndrome
- Helicobacter pylori infection
- Diphyllobothriasis.
◉ Causes of non-megaloblastic macrocytic anemia
- Alcohol consumption
- Liver diseases, such as cirrhosis
- Hereditary spherocytosis
- Hypothyroidism
◉ Symptoms of macrocytic anemia
This disease is often discovered incidentally, as its symptoms are similar to the symptoms of many other diseases. In light of this, reference must be made to the group of diagnostic symptoms that characterize macrocytic anemia, which include:
- Breathing disorders.
- Pale skin.
- Thinning and enlargement of the tongue.
- Unexplained weight loss.
- Unwillingness to eat and loss of appetite.
- Digestive disorders.
- Tingling in the extremities and numbness in the hands and feet.
◉ Complications of macrocytic anemia
In fact, neglecting the treatment of this disease leads to the emergence of many pathological problems, some of which are simple and others that pose a real threat to the patient's life. These complications are mainly related to the factor causing the emergence of the disease, so that the most prominent complications include the following:
- Cancers and tumors, especially in the stomach and colon.
- Memory disorders and Alzheimer's.
- Neural tube problems in the fetus if the patient is pregnant.
- Peripheral neuropathy.
- Movement disorders.
- The emergence of cardiovascular diseases.
- Exposing the pregnant woman to the risk of premature birth.
- Hypertension.
- Hypertrophy of the heart muscle.
◉ Diagnosis of macrocytic anemia
The correct treatment plan depends on an accurate diagnosis, which includes several stages and steps as follows:
1. Clinical history
The first step in diagnosing macrocytic anemia begins with an inquiry about the patient's general condition and clinical history, whereby his medical history is taken and his dietary habits and lifestyle are looked at in order to suggest the most prominent causes of infection.
2. Laboratory analyzes
Considering that this disease is closely related to the blood, a comprehensive blood test must be performed to ascertain some matters and to find out the cause of the infection and the optimal treatment for the condition. These analyzes include:
- Red blood cell count test.
- Integrated bloody summer.
- Tests for thyroid hormones and thyroxine.
- Diagnostic tests for liver diseases.
- Checking blood alcohol levels.
- Peripheral blood smear.
◉ Treatment of macrocytic anemia
It is the most important step that all patients go to in search of the best way to get rid of this disease. It should be noted that the treatment of macrocytic anemia is mainly based on the cause of its infection. Treatment may be pharmacological, nutritional, or appropriate to the patient's condition, according to the following:
◉ Diet therapy
The deficiency in some nutrients that causes the emergence of macrocytic anemia can be compensated for with foods rich in the same missing element. In the event that vitamin B12 deficiency is the cause of the disease, we direct the patient to eat nutrients that contain high levels of this vitamin, which include:
- White meat.
- Sea food.
- Whole grains.
- Eggs.
While if the cause of the injury is a deficiency of folic acid, the nutrients containing it are the first line of treatment, which include:
- Leafy vegetables like spinach.
- Citrus fruits and fresh fruits.
- Legumes.
- Avocado.
◉ Pharmacotherapy
The cause of the infection may be a problem in absorption, and therefore no matter how much the patient eats nutrients and foods containing vitamins, the problem of macrocytic anemia continues to appear and may also worsen! Therefore, parenteral drugs or other drug treatments are resorted to that prevent drug interaction problems and treat the diseases causing them. For the emergence of macrocytic anemia.
◉ The medical treatment
When all previous therapeutic methods fail to treat macrocytic anemia, other medical methods are resorted to, the most important of which are blood transfusions in which the severe deficiency is compensated, and bone marrow transplants that promote the production of normal red blood cells capable of performing their tasks on the face may be resorted to fuller in contrast to those resulting in macrocytic anemia.
◉ Top questions about macrocytic anemia
In addition to the previous information, there are side inquiries for which the reader is looking for accurate answers. Here are some of them:
◉ When should a patient with macrocytic anemia go to the doctor immediately?
A visit to the doctor becomes an urgent necessity when the patient notices the emergence of some new symptoms that cause concern, which include:
- Increase in the number and speed of the heartbeat.
- unjustified confusion.
- Memory disorders.
- Problems with focus and accuracy.
◉ Can macrocytic anemia be prevented?
Although macrocytic anemia is a sudden disease that cannot be completely prevented, there are some advices and guidelines that limit its incidence as much as possible, including:
- Eat white and red meat regularly.
- Adhere to a healthy and balanced diet.
- Limit alcohol intake.
- Do not take medications indiscriminately.
- Conducting laboratory analyzes on a regular basis annually.
◉ Are there serious complications of macrocytic anemia?
The seriousness of the complications of macrocytic anemia lies in the general condition of the patient himself. If the patient is pregnant, her fetus may develop neural tube defects and neurological problems that will always be with him.
Liver patients are considered to be primarily affected by this disease, as they may develop hyperammonemia, ascites, and life-threatening high blood pressure, in addition to the risk of developing esophageal varices, internal hemorrhoids, hepatorenal syndrome, and cerebral hepatopathy.
◉ Conclusion
In conclusion, this was the most important information about macrocytic anemia, its causes, symptoms and types, so that we have provided you with a comprehensive guide about this disease in all its aspects and answered the most common questions related to it, With our wishes of good health and wellness..
