Anemia is a condition in which the body does not have enough red blood cells to deliver oxygen to body tissues. This understandably can result in many problems with the body due to the necessity for proper oxygen supply to body cells and tissues. One type of anemia is known as macrocytic anemia, and it is characterized by larger than normal red blood cells (greater than 100 femtoliter or fL) and can be due to many causes, including vitamin B12 and folate deficiency, alcoholism and any type of malabsorption syndrome.
Mental Signs
Fatigue is common to all anemias and is a result of decreased oxygen supply to body cells, especially the brain. In addition, patients can display confusion and irritability.
Increased Heart Rate
The heart tends to beat faster, which is known as tachycardia, in response to the decreased number of red blood cells. This often causes the heart to increase its own oxygen demand and can often be a cause of heart failure and death in anemic patients.
Neurologic Findings
Vitamin B12 deficiency can result in a macrocytic anemia that also has nervous system findings. These are a result of nerve damage (neuropathy) to the peripheral nerves and can manifest with uncoordinated gait, tingling, numbness and weakness. These symptoms do not occur with other forms of macrocytic anemia. The mechanism of damage is demyelination, or damage to the myelin sheaths that surround the nerves and help with the conduction of nervous impulses.
Gastrointestinal Symptoms
The digestive system also has numerous signs and symptoms that are present when a patient is suffering from macrocytic anemia. They include diarrhea, a sore mouth and tongue, and loss of appetite.
Skin Manifestations
Often there will be visible pallor, or paleness of the skin, and premature graying of the hair.
Muscle Weakness
Weakness of the skeletal muscles is another sign of macrocytic anemia, which can be attributed to both decreased oxygen delivery to the muscles and mental fatigue which can affect the effort a patient can make.
References
- "Hematology: Basic Principles and Practice, 5th Edition;" Ronald Hoffman; 2008
- "Cecil Medicine, 23rd Edition;" Lee Goldman et al; 2007
