{"id":4112,"date":"2022-05-03T11:47:20","date_gmt":"2022-05-03T10:47:20","guid":{"rendered":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/macrocytosisisolated\/"},"modified":"2023-08-31T14:19:26","modified_gmt":"2023-08-31T13:19:26","slug":"macrocytosisisolated","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/haematology\/macrocytosisisolated\/","title":{"rendered":"Macrocytosis (isolated)"},"content":{"rendered":"\n<p><\/p>\n\n\n\n\n\n<h4 class=\"wp-block-heading\">Definition<\/h4>\n\n\n\n<p>MCV above normal range.<\/p>\n\n\n\n<p>PLEASE NOTE:<br>This guidance only refers to patients with isolated macrocytosis.&nbsp; For patients with macrocytosis and additional blood abnormalities (e.g. anaemia, neutropenia, thrombocytopenia, monocytosis, or combinations of abnormalities), please see separate macrocytic anaemia guidance.<\/p>\n\n\n\n<p><strong>C.M &amp; L.W 26-06-23<\/strong><\/p>\n\n\n\n<div class=\"wp-block-getwid-tabs\" data-active-tab=\"0\"><ul class=\"wp-block-getwid-tabs__nav-links\"><\/ul>\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Referral Guidelines<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<h4 class=\"wp-block-heading\">Who to refer:<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Macrocytosis with increased reticulocyte count (WGH, St Johns or RIE)<strong><\/strong><\/li>\n\n\n\n<li>For patients with macrocytosis with any additional full blood count abnormality \u2013 e.g. anaemia, neutropenia, thrombocytopenia, monocytosis, or combinations of abnormalities &#8211; please follow the separate <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/anaemia-macrocytic\/\">macrocytic anaemia guidance<\/a>. <strong><\/strong><\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">Who not to refer:<\/h4>\n\n\n\n<p>Simple macrocytosis, where all the above investigations are normal, (or the macrocytosis persists despite adequate replacement\/treatment), and there are no additional blood count abnormalities. In this case, the patient has<strong> idiopathic macrocytosis<\/strong> and should be reassured that no further tests are needed.<\/p>\n\n\n\n<p>&nbsp;In such cases, it is reasonable to re-check a FBC if the patient develops additional symptoms, or if there is suspicion of additional haematological abnormalities.&nbsp; However, there is no need for regular FBC review.<strong><\/strong><\/p>\n\n\n\n<h4 class=\"wp-block-heading\">How to refer:<\/h4>\n\n\n\n<p>SCI Gateway \u2013 please refer the Department of Haematology WGH, St Johns or RIE if indicated. However please see further detail in notes above.<\/p>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Primary Care Management<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<h3 class=\"wp-block-heading\">Primary care investigations<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>B12 and folate.&nbsp; Treat if deficiency is detected.<\/li>\n\n\n\n<li>Blood film<\/li>\n\n\n\n<li>Reticulocyte count.&nbsp;<\/li>\n\n\n\n<li>Thyroid function tests.&nbsp; Treat if abnormality is detected.<\/li>\n\n\n\n<li>Liver function \u2013 excess alcohol and chronic liver disease commonly cause macrocytosis, sometimes with associated thrombocytopenia<\/li>\n<\/ul>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Resources and Links<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\"><\/div><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Definition MCV above normal range. PLEASE NOTE:This guidance only refers to patients with isolated macrocytosis.&nbsp; For patients with macrocytosis and additional blood abnormalities (e.g. anaemia, neutropenia, thrombocytopenia, monocytosis, or combinations of abnormalities), please see separate macrocytic anaemia guidance. C.M &amp; L.W 26-06-23<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":3981,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"categories":[265],"class_list":["post-4112","page","type-page","status-publish","hentry","category-macrocytosisisolated"],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"NHS Lothian","author_link":"https:\/\/apps.nhslothian.scot\/refhelp\/author\/nhs-lothian\/"},"rttpg_comment":0,"rttpg_category":" <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/category\/haematology\/macrocytosisisolated\/\" rel=\"tag\">Macrocytosis (isolated)<\/a>","rttpg_excerpt":"Definition MCV above normal range. PLEASE NOTE:This guidance only refers to patients with isolated macrocytosis.&nbsp; For patients with macrocytosis and additional blood abnormalities (e.g. anaemia, neutropenia, thrombocytopenia, monocytosis, or combinations of abnormalities), please see separate macrocytic anaemia guidance. C.M &amp; L.W 26-06-23","_links":{"self":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4112","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/comments?post=4112"}],"version-history":[{"count":11,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4112\/revisions"}],"predecessor-version":[{"id":16127,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4112\/revisions\/16127"}],"up":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3981"}],"wp:attachment":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/media?parent=4112"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/categories?post=4112"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}