Folate deficiency laboratory findings: Difference between revisions
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First line investigations include the following: | First line investigations include the following: | ||
*Examination of peripheral blood smear : | * Complete blood count: | ||
* | ** Decreased [[hemoglobin]] and hematocrit levels | ||
** Increased [[mean corpuscular volume]] (MCV >95 fl often >110) and [[mean corpuscular hemoglobin]] (MCH) | |||
** Low corrected reticulocyte count which indicates decreased production by the bone marrow. | |||
** The [[platelet]] count may be reduced. | |||
* Examination of peripheral blood smear : | |||
** [[Neutrophil granulocyte|Neutrophil granulocytes]] may show multisegmented nuclei ("senile [[neutrophil]]"), due to decreased production and a compensatory prolonged lifespan for circulating [[neutrophils]]. | |||
** [[Anisocytosis]] (increased variation in [[RBC]] size) and [[poikilocytosis]] (abnormally shaped RBCs). | |||
** Macrocytes (larger than normal [[RBCs]]) are present. | |||
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ad [[anemia|mia]] [[blood film|m]] | |||
* Complete blood count: | * Complete blood count: | ||
** Decreased [[hemoglobin]] and hematocrit levels | ** Decreased [[hemoglobin]] and hematocrit levels | ||
| Line 31: | Line 37: | ||
** The [[platelet]] count may be reduced. | ** The [[platelet]] count may be reduced. | ||
* Examination of peripheral blood smear : | * Examination of peripheral blood smear : | ||
** [[Neutrophil granulocyte|Neutrophil granulocytes]] may show multisegmented nuclei ("senile [[neutrophil]]") | ** [[Neutrophil granulocyte|Neutrophil granulocytes]] may show multisegmented nuclei ("senile [[neutrophil]]"), due to decreased production and a compensatory prolonged lifespan for circulating [[neutrophils]]. | ||
** [[Anisocytosis]] (increased variation in [[RBC]] size) and [[poikilocytosis]] (abnormally shaped RBCs). | ** [[Anisocytosis]] (increased variation in [[RBC]] size) and [[poikilocytosis]] (abnormally shaped RBCs). | ||
** Macrocytes (larger than normal [[RBCs]]) are present. | ** Macrocytes (larger than normal [[RBCs]]) are present. | ||
** | ** | ||
* [[Bone marrow]] (not normally checked in a patient suspected of [[megaloblastic anemia]]) shows megaloblastic [[hyperplasia]]. | * [[Bone marrow]] (not normally checked in a patient suspected of [[megaloblastic anemia]]) shows megaloblastic [[hyperplasia]]. | ||
* [[Howell-Jolly body|Howell-Jolly bodies]] ([[chromosomal]] remnant) also present. | * [[Howell-Jolly body|Howell-Jolly bodies]] ([[chromosomal]] remnant) also present. | ||
Revision as of 10:54, 28 January 2019
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Overview
Laboratory Findings
First line investigations include the following:
- Complete blood count:
- Decreased hemoglobin and hematocrit levels
- Increased mean corpuscular volume (MCV >95 fl often >110) and mean corpuscular hemoglobin (MCH)
- Low corrected reticulocyte count which indicates decreased production by the bone marrow.
- The platelet count may be reduced.
- Examination of peripheral blood smear :
- Neutrophil granulocytes may show multisegmented nuclei ("senile neutrophil"), due to decreased production and a compensatory prolonged lifespan for circulating neutrophils.
- Anisocytosis (increased variation in RBC size) and poikilocytosis (abnormally shaped RBCs).
- Macrocytes (larger than normal RBCs) are present.
| Reference Range | |
| Folic Acid in Serum/Plasma Deficiency | 3.6-15 mg/dl |
| Adequate Folic Acid Supply | > 4 ug/l |
| Erythrocyte Folic Acid | 120-800 ug/l |
- Complete blood count:
- Decreased hemoglobin and hematocrit levels
- Increased mean corpuscular volume (MCV >95 fl often >110) and mean corpuscular hemoglobin (MCH)
- Low corrected reticulocyte count which indicates decreased production by the bone marrow.
- The platelet count may be reduced.
- Examination of peripheral blood smear :
- Neutrophil granulocytes may show multisegmented nuclei ("senile neutrophil"), due to decreased production and a compensatory prolonged lifespan for circulating neutrophils.
- Anisocytosis (increased variation in RBC size) and poikilocytosis (abnormally shaped RBCs).
- Macrocytes (larger than normal RBCs) are present.
- Bone marrow (not normally checked in a patient suspected of megaloblastic anemia) shows megaloblastic hyperplasia.
- Howell-Jolly bodies (chromosomal remnant) also present.
Blood chemistries will also show:icai in
- Increased homocysteine in folate deficency