Causes of macrocytic anemia among 628 patients: mean corpuscular volumes of 114 and 130 fL as critical markers for categorization
Causes of macrocytic anemia among 628 patients: mean corpuscular volumes of 114 and 130 fL as critical markers for categorization
复制标题
DOI：
10.1007/s12185-016-2043-x
复制
发表时间：
2016-09-01
影响因子：
2.1
通讯作者：
Harigae, Hideo
中科院分区：
文献类型：
--
作者：
Takahashi, Natsuko;Kameoka, Junichi;Harigae, Hideo
目前还没有关于巨细胞性贫血病因与平均红细胞体积(MCV)截断值的关系的研究。我们回顾了628名来东北大学医院血液科门诊就诊的患者中巨细胞性贫血(MCV Aeyen100 Fl)的原因。为了确保数据的有效性，我们还分析了东北地区其他八家医院的307名患者的数据。在东北大学医院，巨细胞性贫血的主要原因是骨髓增生异常综合征(121例，19.3%)、疑似骨髓衰竭综合征(74例，11.8%)、再生障碍性贫血(51例，8.1%)、浆细胞营养不良(45例，7.2%)和维生素B12缺乏(40例，6.4%)。我们有三个主要发现如下。首先，巨细胞性贫血最常见的原因是BMF。其次，淋巴样和实体恶性肿瘤也是引起巨细胞增多症的常见原因。第三，巨幼细胞性贫血可分为三组：第一组(巨幼细胞性贫血及药物)，可超过MCV 130fl；第二组(酒精中毒/肝病、BMF、髓系恶性肿瘤、溶血性贫血)，可超过MCV114fl；第三组(淋巴系恶性肿瘤、慢性肾功能衰竭、甲状腺功能减退、实体瘤)，不超过MCV114fl。这些结论得到了来自其他八家医院的结果的支持。
There have been no studies on the distribution of causes of macrocytic anemia with respect to mean corpuscular volume (MCV) cutoff values. We retrospectively investigated the causes of macrocytic anemia (MCV aeyen100 fL) among 628 patients who visited the outpatient hematology clinic in Tohoku University Hospital. To ensure data validity, we also analyzed data from 307 patients in eight other hospitals in the Tohoku district. The leading causes of macrocytic anemia (number of patients, %) were myelodysplastic syndromes (121, 19.3 %), suspected bone marrow failure syndromes (BMF; 74, 11.8 %), aplastic anemia (51, 8.1 %), plasma cell dyscrasia (45, 7.2 %), and vitamin B12 deficiency (40, 6.4 %) in Tohoku University Hospital. We made three primary findings as follows. First, the most common cause of macrocytic anemia is BMF. Second, lymphoid and solid malignancies are also common causes of macrocytosis. Third, macrocytic anemia may be classified into three groups: Group 1 (megaloblastic anemia and medications), which can exceed MCV 130 fL; Group 2 (alcoholism/liver disease, BMF, myeloid malignancy, and hemolytic anemia), which can exceed MCV 114 fL; and Group 3 (lymphoid malignancy, chronic renal failure, hypothyroidism, and solid tumors), which does not exceed MCV 114 fL. These conclusions were supported by the results from eight other hospitals.