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After 2 years, he was admitted because of macrocytic anemia.
When the MCV is elevated, the RBCs will be larger than normal and are termed macrocytic.
Macrocytic cells occur when division of RBC precursor cells in the bone marrow is impaired.
The most common causes of macrocytic anemia are vitamin B 12 deficiency, folate deficiency, and liver disease.
The MCH is usually elevated in macrocytic anemias associated with vitamin B 12 and folate deficiency.