A 3-year-old boy who recently emigrated from Ghana is brought to the physician for health care follow up. He has had episodes of pain and swelling in his hands in the past. His family history is significant for an older brother who died of pneumococcal sepsis at age 5. His hemoglobin electrophoresis results are consistent with sickle cell disease (hemoglobin SS). Further laboratory evaluation shows a mean corpuscular volume of 113 µm³ Which of the following is the most likely cause of this patient's macrocytosis?

Question

Quizplus · Accepted Answer

Eductional Objective: An MCV >110 µm³ is highly suggestive of megaloblastic anemia, such as that caused by folic acid or vitamin B₁₂ deficiency. Patients with chronic hemolytic anemia have increased folic acid requirements due to increased erythrocyte turnover and are predisposed to developing macrocytosis.

A 3-Year-Old Boy Who Recently Emigrated from Ghana Is Brought