Evaluation and Practical Approach to Pediatric Macrocytosis: A Comprehensive Analysis

Abstract

Laura Ximena Contreras Ramirez, Iliana De Los Reyes Valencia, Eduardo Blanco Camacho, Paula Carolina Guzman Cruz and Sandra Milena Mantilla Mejia

Macrocytic anemia is relatively rare in children [1]. Macrocytosis is defined as a mean corpuscular volume (MCV) greater than 100 fL, with clinical significance when it exceeds 115 fL. It is often detected during a routine complete blood count (CBC) [2]. Elevated MCV is often associated with an increase in mean corpuscular hemoglobin (MCH). Therefore, high MCV and MCH values suggest macrocytosis. In some cases, the detection of macrocytosis may not require further testing or treatment. However, clinicians must understand the importance of macrocytosis in the potential development of clinically significant anemia (macrocytic anemia) and recognize the wide range of etiologies that contribute to it.

Macrocytic anemia can be classified into two main types: megaloblastic anemia, characterized by hypersegmented neutrophils and macroovalocytes, and non-megaloblastic anemia, which involves round macrocytes. Megaloblastic anemia is the most common type [3,4].

Treatment of macrocytic anemia is directed at the specific cause [3].

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