Blood color: anemia is not obvious in mild cases, but obvious anemia in severe cases, which is macrocytic orthochromatic. MCV is increased parallel to the degree of anemia, up to 110-16Ofl in severe cases, MCH is increased, up to 33-56pg in severe cases, MCHC is normal, MCD (mean diameter) and MCT (mean thickness) are larger than normal. Blood film erythrocyte size is not uniform, with oval-shaped large red blood cells mostly stained darker, the severe cases can be seen polychromatic and basophilic dots color red blood cells occasionally (cabot ring and Haved-Jolly) bodies and nucleated erythrocytes (megaloblasts), reticulocytes are often reduced, there are also normal or slightly higher. Granulocytes are mildly reduced, neutrophils are lobed too much, those with more than 5 lobes are >3%, granulocyte megacytosis is seen, occasionally giant rod and giant late juvenile granulocytes platelets are mildly reduced, this experiment is from Mudanjiang Medical College, the undergraduate 5-year laboratory guide for laboratory tests.
Operation method
Megaloblastic anemia analytical test Move Blood color: anemia is not obvious in mild cases, but obvious anemia in severe cases, which is macrocytic orthochromatic. MCV is increased parallel to the degree of anemia, up to 110-16Ofl in severe cases, MCH is increased, up to 33-56pg in severe cases, MCHC is normal, MCD (mean diameter) and MCT (mean thickness) are larger than normal. Blood film erythrocyte size is not uniform, with oval-shaped large red blood cells mostly stained darker, the severe cases can be seen polychromatic and basophilic dots color red blood cells occasionally (cabot ring and Haved-Jolly) bodies and nucleated erythrocytes (megaloblasts), reticulocytes are often reduced, there are also normal or slightly higher. Granulocytes are mildly decreased, neutrophils are excessively lobulated, >3% of all 5 or more lobes, granulocyte megacytosis is seen, occasionally giant rods and giant late juvenile granulocytes Platelets are mildly decreased, and giant platelets are seen. For more product details, please visit Aladdin Scientific website.
Bone marrow picture:
l. General changes Bone marrow nucleated cells are increased, mainly megaloblastic erythropoiesis, which has a parallel relationship with anemia. It may occupy 30-50% of the nucleated cells. The granulocyte lineage may also have megaloblastic changes and can be seen in the early stages of the disease, mainly in granulocytes below the mesophilic level. The cytosol is large and the nucleus is swollen. Chromatin is loose, cytoplasmic granules are fewer, and vacuoles can be seen. The megakaryocytes are reduced, the cytosol is large, the lobes are excessive, the cytoplasmic granules are reduced, the bone marrow iron is increased, the bone marrow megaloblastic erythrocytes are very sensitive to the treatment of folic acid and VB12, and can be converted to normal erythrocyte series within 48 hours (24-72 hours) of the use of the drug, but the recovery of megaloblastic changes in the granular lineage is delayed.
2. Morphological changes Compared with normal erythrocytes of the same stage, megaloblastic erythrocytes have larger cytosol, unbalanced development of nucleus and plasma, and delayed development of nucleus with "young nucleus and old plasma" change of chromatin is more sparse and detailed, nuclear division is common, cytoplasm is more, and the synthesis of mature hemoglobin of the nucleus is normal, and the morphology of megaloblastic erythrocytes of each stage is as follows:
(1) the original megaloblasts are larger than the original red blood cells, 19-27 microns slightly oval. Cytosolic nucleus is often biased, chromatin is more detailed than the original erythrocytes, loose and uniform, was a fine mesh. The cytoplasm is more abundant, dark blue and opaque.
(2) Early giant juvenile erythrocytes 12-20 microns, nuclear chromatin loose and uniform. Like fine particles composed of a network, (mesh sub-staining) clear, the nucleolus disappeared or there are remnants of the nuclear periphery is obvious, the cytoplasm is dark blue, opaque, slightly lighter near the nucleus, some have begun to appear haemoglobin and gray-blue. Split type is common.
(3) in the giant red blood cells 12-20 microns. Often young nuclei with old plasma, round or irregular nuclei, binucleated or multinucleated, chromatin dotted color or reticulation, cytoplasm gray-blue, reddish or reddish, split type is common.
(4) Late giant juvenile erythrocytes 9-18 microns, the nucleus is small, paranuclear, dense chromatin, some chromatin has been linked into pieces, most of the chromatin can still be seen coarse dotted color or coarse reticulate traces, between which there is a transparent area can be seen. Common nuclear lobes, buds, creases, serrated nuclear fragmentation, Howell a Jolly vesicles, cytoplasmic rich, orange-red, the same color as the mature erythrocytes, or slightly gray.
(5) Macrocytes >9 microns, round or oval in shape. Stained bright orange-red, the central stained area is often inconspicuous or completely disappeared.