Which physical findings are characteristic of macrocytosis?

Updated: Dec 16, 2020
  • Author: Vincent E Herrin, MD, FACP; Chief Editor: Emmanuel C Besa, MD  more...
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The following physical findings may be noted:

  • Glossitis suggests that the macrocytosis stems from deficiency of vitamin B12, folate, or both.
  • Tachycardia is usually modest and is common in patients with severe anemia.
  • Flow murmurs usually are noted only in patients with severe anemia.
  • Splenomegaly may be quite remarkable when the macrocytosis is due to hemolysis, infiltrative disorders, or neoplasms.
  • Jaundice suggests liver disease or hemolysis, both of which may lead to an increased MCV.
  • Conjunctival pallor is evident in patients with severe anemia.
  • Neurologic disorders, such as ataxia, loss of posterior column sensations, loss of deep tendon reflexes (particularly ankle reflex), and confabulation, may suggest thiamine deficiency.

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