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Fatigue and AnemiaFatigue and Anemia
           
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enlarged red blood cells
Mar 20, 2001

can you tell me the relevence if the red blood cells are found to be enlarged?

Response from Dr. Frascino

Hi,

Enlarged red blood cells are called macrocytes. Since this forum is designed for issues pertaining to HIV-related fatigue and anemia, I'll assume you need information on enlarged blood cells as the condition relates to anemia. This group of illnesses is termed macrocytic anemias and includes:

* Pernicious anemia, malabsorption, and fish tapeworm infection, all of which result in a deficiency of cobalamin. Cobalamin (vitamin B12) deficiency leads to macrocytic anemia. * Nutritional deficiency, alcohol abuse, malabsorption, medication toxicity, and selected medical conditions like pregnancy, all of which can lead to folic acid deficiency. Like Cobalamin deficiency, folic acid deficiency results in macrocytic anemia with enlarged red blood cells. * Hemolytic anemia. In this condition, red blood cells are destroyed and the bone marrow tries to compensate by making new red blood cells in the bone marrow and pushing them out early into the circulation. These early red blood cells are called reticulocytes and are larger than normal mature red blood cells. * Liver disease * Myelodysplasia, a medical condition where the normal maturation of red blood cells is defective. * HIV medications, particularly AZT (retrovir, combivir, trizivir); TMP/SMX (Bactrim, Septra); ganciclovir, dapsone, pyrimethamine, interferon, and cancer chemotherapy.

The treatment, of course, depends on the cause. Vitamin deficiencies are treated by supplementation. AZT-related anemia can be treated by switching to an alternative medication or with Procrit, a synthetic hormone that stimulates your bone marrow to make additional red blood cells.

That may have been more information that you wanted, but hey, we're an information resource. So hopefully, you found it helpful. Mildly enlarged red blood cells without associated anemia, as seen with many HIV cocktails, particularly those that contain AZT) are generally not problematic, but should be monitored.

If anemia develops, the appropriate treatment should be undertaken.

Good luck.

RJF


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