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Prevalence of potential underlying aetiology of macrocytic anaemia in Dutch general practice

Overview of attention for article published in BMC Family Practice, August 2016
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Title
Prevalence of potential underlying aetiology of macrocytic anaemia in Dutch general practice
Published in
BMC Family Practice, August 2016
DOI 10.1186/s12875-016-0514-z
Pubmed ID
Authors

Karlijn Stouten, Jurgen A. Riedl, Jolanda Droogendijk, Rob Castel, Joost van Rosmalen, Ron J. van Houten, Paul Berendes, Pieter Sonneveld, Mark-David Levin

Abstract

Macrocytic anaemia (MCV ≥ 100 fL) is a relatively common finding in general practice. However, literature on the prevalence of the different causes in this population is limited. The prevalence of macrocytic anaemia and its underlying aetiology were analysed in a general practice population. The potential effect of the different aetiology on survival was also evaluated. Between the 1st of February 2007 and the 1st of February 2015, patients aged 50 years or older and presenting to their general practitioner with a newly diagnosed anaemia, were included in the study. Anaemia was defined as haemoglobin level below 13.7 g/dL in men and below 12.1 g/dL in women. A broad range of laboratory tests was performed for each patient. The causes of anaemia were consequently determined by two independent observers based on the laboratory results. Of the 3324 included patients, 249 (7.5 %) displayed a macrocytic anaemia and were subsequently analysed. An underlying explanation could be established in 204 patients (81.9 %) with 27 patients (13.2 %) displaying multiple causes. Classic aetiology (i.e. alcohol abuse, vitamin B12/folic acid deficiency, haemolysis and possible bone marrow disease) was found in 115 patients. Alternative causes (i.e. anaemia of chronic disease, iron deficiency, renal anaemia and other causes) were encountered in 101 patients. In addition, a notable finding was the median gamma GT of 277 U/L in patients diagnosed with alcohol abuse (N = 24, IQR 118.0-925.5) and 23 U/L in the remaining cohort (N = 138, IQR 14.0-61.0). The distribution of gamma GT values was statistically different (P < 0.001). Five year survival rates were determined for six categories of causes, ranging from 39.9 % (95 % CI 12.9-66.9) for renal anaemia to 76.2 % (95 % CI 49.4-103.0) for the category multiple causes. In addition to classic explanations for macrocytosis, alternative causes are frequently encountered in patients with macrocytic anaemia in general practice.

Mendeley readers

The data shown below were compiled from readership statistics for 21 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 21 100%

Demographic breakdown

Readers by professional status Count As %
Student > Bachelor 4 19%
Student > Ph. D. Student 2 10%
Researcher 2 10%
Student > Master 2 10%
Unspecified 2 10%
Other 9 43%
Readers by discipline Count As %
Medicine and Dentistry 12 57%
Nursing and Health Professions 3 14%
Unspecified 3 14%
Biochemistry, Genetics and Molecular Biology 2 10%
Psychology 1 5%
Other 0 0%