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Unexplained macrocytosis

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dc.contributor.author Younes M.
dc.contributor.author Dagher G.A.
dc.contributor.author Dulanto J.V.
dc.contributor.author Njeim M.
dc.contributor.author Kuriakose P.
dc.contributor.editor
dc.date Feb-2013
dc.date.accessioned 2017-10-05T15:34:25Z
dc.date.available 2017-10-05T15:34:25Z
dc.date.issued 2013
dc.identifier 10.1097/SMJ.0b013e3182824cdf
dc.identifier.isbn
dc.identifier.issn 00384348
dc.identifier.uri http://hdl.handle.net/10938/15488
dc.description.abstract OBJECTIVES: Macrocytosis is a relatively common finding in adult patients undergoing blood cell counting. Approximately 10percent of patients will have unexplained macrocytosis after laboratory evaluation. Data on the approach to patients with unexplained macrocytosis are limited. METHODS: To investigate this topic and help delineate an approach to this condition, the records of 9779 patients diagnosed in our institution between 1995 and 2005 as having macrocytosis were reviewed. Patients with evidence of liver disease, alcohol abuse, hypothyroidism, folate or vitamin B12 deficiency, hemolysis, or use of any drugs known to cause macrocytosis were excluded. RESULTS: Forty-three patients were found to have unexplained macrocytosis. The median follow-up was 4 years. A total of 11.6percent patients developed a primary bone marrow disorder (two B-cell lymphomas, two with myelodysplastic syndrome, one plasma cell disorder), 16.3percent developed worsening cytopenias, 69.7percent had stable disease, and 2.3percent resolved. The median time to first cytopenia was 18 months, and the mean time to diagnosis of bone marrow disorder was 31.6 months. The outcomes were not significantly different when comparing patients with or without anemia upon diagnosis. The probability of a bone marrow biopsy to establish a diagnosis of a primary disorder was 33.3percent in patients with macrocytosis without anemia compared with 75percent in patients with macrocytosis with anemia. CONCLUSIONS: Patients with unexplained macrocytosis still require close follow-up. We suggest a strategy of follow-up with blood cell counting every 6 months. Bone marrow biopsy should be performed when cytopenias are present because this approach may provide a higher yield of diagnosis and aid with therapeutic decisions.Copyright © 2013 The Southern Medical Association.
dc.format.extent
dc.format.extent Pages: (121-125)
dc.language English
dc.publisher PHILADELPHIA
dc.relation.ispartof Publication Name: Southern Medical Journal; Publication Year: 2013; Volume: 106; no. 2; Pages: (121-125);
dc.relation.ispartofseries
dc.relation.uri
dc.source Scopus
dc.subject.other
dc.title Unexplained macrocytosis
dc.type Article
dc.contributor.affiliation Younes, M., Henry Ford Hospital, 2799 W Grand Blvd, Detroit, MI 48202, United States, American University of Beirut Medical Center, Beirut, Lebanon
dc.contributor.affiliation Dagher, G.A., Henry Ford Hospital, 2799 W Grand Blvd, Detroit, MI 48202, United States, American University of Beirut Medical Center, Beirut, Lebanon
dc.contributor.affiliation Dulanto, J.V., Henry Ford Hospital, 2799 W Grand Blvd, Detroit, MI 48202, United States, American University of Beirut Medical Center, Beirut, Lebanon
dc.contributor.affiliation Njeim, M., Henry Ford Hospital, 2799 W Grand Blvd, Detroit, MI 48202, United States, American University of Beirut Medical Center, Beirut, Lebanon
dc.contributor.affiliation Kuriakose, P., Henry Ford Hospital, 2799 W Grand Blvd, Detroit, MI 48202, United States, American University of Beirut Medical Center, Beirut, Lebanon
dc.contributor.authorAddress Younes, M.; Henry Ford Hospital, 2799 W Grand Blvd, Detroit, MI 48202, United States; email: myounis83@hotmail.com
dc.contributor.authorCorporate University: American University of Beirut Medical Center; Faculty: Faculty of Medicine; Department: Emergency Medicine;
dc.contributor.authorDepartment Emergency Medicine
dc.contributor.authorDivision
dc.contributor.authorEmail myounis83@hotmail.com
dc.contributor.authorFaculty Faculty of Medicine
dc.contributor.authorInitials Younes, M
dc.contributor.authorInitials Abou Dagher, G
dc.contributor.authorInitials Dulanto, JV
dc.contributor.authorInitials Njeim, M
dc.contributor.authorInitials Kuriakose, P
dc.contributor.authorOrcidID
dc.contributor.authorReprintAddress Younes, M (reprint author), Henry Ford Hosp, 2799 W Grand Blvd, Detroit, MI 48202 USA.
dc.contributor.authorResearcherID
dc.contributor.authorUniversity American University of Beirut Medical Center
dc.description.cited ANTTILA P, 1995, BRIT J HAEMATOL, V90, P797, DOI 10.1111-j.1365-2141.1995.tb05198.x; BREEDVELD FC, 1981, ACTA MED SCAND, V209, P319; COLONOTERO G, 1992, MED CLIN N AM, V76, P581; DAVIDSON RJL, 1978, J CLIN PATHOL, V31, P493, DOI 10.1136-jcp.31.5.493; DONOFRIO G, 1995, BLOOD, V85, P818; HATTERSL.PG, 1971, AM J CLIN PATHOL, V55, P442; Hoffbrand V, 1997, BRIT MED J, V314, P430; Horstman AL, 2005, EUR J HAEMATOL, V75, P146, DOI 10.1111-j.1600-0609.2005.00441.x; Khalife MA, 2010, BLOOD, V116, P1925; LINDENBAUM J, 1983, BLOOD, V61, P624; Ma X, 2007, CANCER, V109, P1536, DOI 10.1002-cncr.22570; Mahmoud MY, 1996, AGE AGEING, V25, P310, DOI 10.1093-ageing-25.4.310; National Cancer Institute, SEER CANC STAT REV 1; WYMER A, 1990, J GEN INTERN MED, V5, P192, DOI 10.1007-BF02600531; YOUNG M, 1975, J CLIN PATHOL, V28, P12, DOI 10.1136-jcp.28.1.12
dc.description.citedCount 1
dc.description.citedTotWOSCount 1
dc.description.citedWOSCount 1
dc.format.extentCount 5
dc.identifier.articleNo
dc.identifier.coden SMJOA
dc.identifier.pubmedID 23380746
dc.identifier.scopusID 84873389807
dc.identifier.url
dc.publisher.address 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA
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dc.relation.ispartofConferenceCode
dc.relation.ispartofConferenceDate
dc.relation.ispartofConferenceHosting
dc.relation.ispartofConferenceLoc
dc.relation.ispartofConferenceSponsor
dc.relation.ispartofConferenceTitle
dc.relation.ispartofFundingAgency
dc.relation.ispartOfISOAbbr South.Med.J.
dc.relation.ispartOfIssue 2
dc.relation.ispartOfPart
dc.relation.ispartofPubTitle Southern Medical Journal
dc.relation.ispartofPubTitleAbbr South. Med. J.
dc.relation.ispartOfSpecialIssue
dc.relation.ispartOfSuppl
dc.relation.ispartOfVolume 106
dc.source.ID WOS:000314715600001
dc.type.publication Journal
dc.subject.otherAuthKeyword cytopenias
dc.subject.otherAuthKeyword macrocytosis
dc.subject.otherAuthKeyword myelodysplatic syndrome
dc.subject.otherChemCAS
dc.subject.otherIndex adult
dc.subject.otherIndex aged
dc.subject.otherIndex anemia
dc.subject.otherIndex article
dc.subject.otherIndex B cell lymphoma
dc.subject.otherIndex bone marrow biopsy
dc.subject.otherIndex bone marrow disease
dc.subject.otherIndex clinical article
dc.subject.otherIndex cytopenia
dc.subject.otherIndex deterioration
dc.subject.otherIndex female
dc.subject.otherIndex follow up
dc.subject.otherIndex human
dc.subject.otherIndex male
dc.subject.otherIndex mean corpuscular volume
dc.subject.otherIndex medical record review
dc.subject.otherIndex megalocytosis
dc.subject.otherIndex myelodysplastic syndrome
dc.subject.otherIndex paraproteinemia
dc.subject.otherIndex plasma cell dyscrasia
dc.subject.otherIndex prognosis
dc.subject.otherIndex retrospective study
dc.subject.otherIndex Adult
dc.subject.otherIndex Age Factors
dc.subject.otherIndex Aged
dc.subject.otherIndex Aged, 80 and over
dc.subject.otherIndex Anemia, Macrocytic
dc.subject.otherIndex Biopsy
dc.subject.otherIndex Bone Marrow
dc.subject.otherIndex Erythrocytes, Abnormal
dc.subject.otherIndex Female
dc.subject.otherIndex Follow-Up Studies
dc.subject.otherIndex Humans
dc.subject.otherIndex Leukopenia
dc.subject.otherIndex Logistic Models
dc.subject.otherIndex Lymphoma, B-Cell
dc.subject.otherIndex Male
dc.subject.otherIndex Middle Aged
dc.subject.otherIndex Myelodysplastic Syndromes
dc.subject.otherIndex Paraproteinemias
dc.subject.otherIndex Retrospective Studies
dc.subject.otherIndex Thrombocytopenia
dc.subject.otherKeywordPlus ANEMIA
dc.subject.otherKeywordPlus HEMATOLOGY
dc.subject.otherKeywordPlus DIAGNOSIS
dc.subject.otherKeywordPlus VOLUME
dc.subject.otherWOS Medicine, General and Internal


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