TY  - CHAP
M1  - Book, Section
TI  - MACROCYTIC ANEMIAS
A1  - Hillman, Robert S.
A1  - Ault, Kenneth A.
A1  - Leporrier, Michel
A1  - Rinder, Henry M.
Y1  - 2016
N1  - 
T2  - Hematology in Clinical Practice, 5e
AB  - CASE  HISTORY  •  Part  1A  42-year-old  male  presents  to  the  emergency  room  confused  and  combative  with  alcohol  on  his  breath.  He  has  a  history  of  chronic  alcoholism,  alcoholic  liver  disease,  and  dementia.  He  had  been  "dry"  for  almost  a  year  before  resuming  drinking  a  month  ago.  On  examination  he  has  normal  vital  signs,  a  sallow  complexion,  and  multiple  bruises  over  both  shins  and  forearms.  Liver  and  spleen  are  both  palpable.  Neurological  examination  is  notable  for  stocking  glove  anesthesia  and  poor  position  sense.  Routine  labs  are  ordered:CBC:  Hematocrit/hemoglobin  -  29%/9  g/dLMCV  -  107  fL  MCH  -  34  pg  MCHC  -  32  g/dLRDW-CV  -  15%RDW-SD  -  55  fLReticulocyte  count/index  -1.5%/<1White  cell  count  -  5,300/μLPlatelet  count  -  65,000/μLBLOOD  SMEAR  MORPHOLOGYMixed  population  of  normocytic  and  macrocytic  red  cells  with  moderate  aniso-  and  poikilocytosis,  polychromasia,  and  the  occasional  target  cell.A  bone  marrow  aspirate  is  also  obtained  and  on  preliminary  reading  shows  a  relatively  hypercellular  marrow  with  a  ratio  of  erythroid  to  granulocytic  precursors  (E/G  ratio)  of  1:1,  megaloblastic  maturation  of  both  the  erythroid  and  granulocyte  progenitors,  and  normal  megakaryocyte  numbers.QuestionsHow  should  this  anemia  be  described?What  is  the  differential  diagnosis?What  additional  tests  are  in  order?  
SN  - 
PB  - McGraw-Hill Medical
CY  - New York, NY
Y2  - 2024/04/19
UR  - accessbiomedicalscience.mhmedical.com/content.aspx?aid=1127765912
ER  -