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Forum Name: Hematology Topics

Question: Low Ferritin and Macrocytosis


 bluetopaz - Wed Apr 08, 2009 2:29 am

I am 45 yr female. My Ferritin has been low for at least 7 years, regardless of illness, inflammation, pneumonia.. just now it raised to 21, barely normal. For what I have read, low ferritin usually causes microcytosis, however I have mild macrocytosis already 1.5 years, now 101. Also WBC has been low to borderline low, 3700-4100, when two years ago it was about 5000-5200. What can this all mean? Vit-12 and folate are normal, serum iron has drastically jumped 59 to 130. Can I be loosing blood, or having bone marrow problems?
 Dr.M.jagesh kamath - Fri Aug 27, 2010 3:52 am

User avatar Hello,A low ferritin represents lower iron body storage.The jump in iron levels might indicate improvement either due to therapy or better diet.
Macrocytosis with out anemia can be physiological.This variation may also be seen in family members and thus may be considered as hereditary and would not need investigations in the absence of clinical features.To determine the cause of macrocytosis could be challenging if there is associated iron deficiency or a thallesemia trait.Hepatitis,liver disease,alcoholism, hypothyroidism could all present macrocytosis.Presumably alcohol has direct effect on red cell morphology.Increased reticulocyte count polychromasia,and nucleated RBC may suggest a bleed or hemolysis.
If there are immature cells in the peripheral smears or cytopenias a bonemarrow is required.
Do consult a hematologist.Best wishes.

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