Dr. Seppä and colleagues also reported on hematologic morphologic features in nonanemic patients with macrocytosis due to alcohol abuse or vitamin B12 deficiency.4 They studied 136 patients with alcohol abuse and normal B12 levels, and 18 patients with pernicious anemia. The combination of a low red cell count or a high red cell distribution width with a normal platelet count was found in 94.4% of the vitamin-deficient patients but in only 14.6% of the abusers.
Dr. Douglas S. Paauw
Pearl:
Dr. Paauw is professor of medicine in the division of general internal medicine at the University of Washington, Seattle, and he serves as third-year medical student clerkship director at the university. Contact Dr. Paauw at dpaauw@uw.edu.