فقر الدم كبير الحجم: دراسة سببية و مقاربة تشخيصية خبرة مشفى الأسد الجامعي باللاذقية
Abstract
يعد ارتفاع الـMCV مشكلة سريرية شائعة، لكن لم يتم حتى الآن تحديد طيف مسبباته بدقة، أو إيجاد طريقة تشخيص مثالية له.
أجريت الدراسة بهدف تحديد الأسباب الأكثر شيوعا ً لارتفاع الـMCV ، والوصول إلى المقاربة التشخيصية المثالية له. حيث شملت الدراسة 50 مريضا ً بالغا ً لديهم قيم MCV≥100 fl تم انتقاؤهم عشوائيا خلال سنة واحدة من المرضى المراجعين لمشفى الأسد الجامعي والوحدات المهنية التابعة له.
تضمن التقييم:
دراسة التعداد العام والصيغة - فلم الدم - اختبارات وظائف الكبد - عيار الكوبولامين في المصل وعند بعض المرضى بزل النقي و معايرة حمض الفوليك .
كان السبب الأكثر شيوعا ً لارتفاع الـMCV المعالجة الدوائية ثم فقر الدم العرطل حيث شكلا معا ً أكثر من نصف الحالات، يليهما اضطرابات النقي، ثم أمراض الكبد، ثم فرط الشبكيات أما الكحولية فشكلت 2% من الحالات فقط .
Elevation of mean cell volume (MCV) is a common clinical problem; but the etiologic spectrum and optimal diagnostic evaluation of macrocytosis are not well defined.
The aim of this study is to determine the most common causes and the best diagnostic evaluation of macrocytosis.
This study includes 50 hospitalized patients with MCV values ≥100 fl.
Assessment included complete blood count, morphologic review, liver function tests, levels of serum cobalamin (Cbl), and in some patients marrow biopsy and levels of serum folate.
Drugs and megaloplastic hematopoiesis are the most common causes of macrocytosis (more than 50% of patients), then come marrow disorders, liver disease and reticlocytosis; alcoholism is only found in 2% of the cases.
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