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Laboratory Medicine Report

Masked macrocytosis and the use of serum vitamin B12 and folate assays

Richard A. Savage, M.D. and Ralph Green, M.D.
Cleveland Clinic Journal of Medicine December 1983, 50 (4) 439-444;
Richard A. Savage
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Ralph Green
Department of Laboratory Hematology, The Cleveland Clinic Foundation.
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ABSTRACT

A case of "masked" macrocytosis in an iron and folate deficient male alcoholic is presented. Reliance on algorithms based on mean corpuscular volume (MCV) values for decision-making in the workup of anemic patients may, occasionally, produce diagnostic difficulties, and combination deficiencies or concomitant disease states may affect test interpretation. Appropriate use of radioisotopic dilution assays for vitamin B12 and folate depends on careful clinical observation, blood count, and screening examination of the peripheral smear before confirmatory tests are ordered.

Index terms
  • Anemia
  • macrocytic
  • Folic acid deficiency
  • Vitamin B12 deficiency
  • Received August 1983.
  • Accepted September 1983.
  • Copyright © 1983 The Cleveland Clinic Foundation. All Rights Reserved.
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Cleveland Clinic Journal of Medicine: 50 (4)
Cleveland Clinic Journal of Medicine
Vol. 50, Issue 4
21 Dec 1983
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Masked macrocytosis and the use of serum vitamin B12 and folate assays
Richard A. Savage, Ralph Green
Cleveland Clinic Journal of Medicine Dec 1983, 50 (4) 439-444;

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Masked macrocytosis and the use of serum vitamin B12 and folate assays
Richard A. Savage, Ralph Green
Cleveland Clinic Journal of Medicine Dec 1983, 50 (4) 439-444;
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  • Folic acid deficiency
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