As far as macrocytosis goes, this is my highest MCV(mean corpuscular volume) ever: 114. Differential diagnosis anyone? I tell my residents and students I work with that the differential diagnosis is pretty limited. Most commonly
- alcohol abuse
- liver disease (usually related to alcohol)
- hypothyroidism (although I've never seen an MCV that high from thyroid)
- B12/folate deficiency
- primary bone marrow failure, usually myelodysplastic syndrome.
- drug related (certain types of chemo etc...)
I had a patient once who presented with nonspecific complaints and had an MCV of 110 and nothing else. They denied alcohol use or even abuse. I confronted them with my suspicions about alcohol abuse based on this abnormal lab and they broke down in tears about their long standing closet drinking.
see my other record clinical findings.