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Megaloblastic Macrocytic Anemia: Sensitivity and Specificity

Introduction: This is one of the principal mainfestations of Vitamin B12 (cobalamin) deficiency. It is the sole manifestation of Folate Deficiency in the adult. The other major manifestation of B12 deficiency is neurological: subacute combined degeneration of the spinal column and/or dementia. One common cause of B12 deficiency is Pernicious Anemia.

Other causes of macrocytic anemia include Alcoholism, reticulocytosis, and MDS.

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Tags: Hematologic Metabolic Tag this Diagnosis.

The sensitivity and specificity of findings for Megaloblastic Macrocytic Anemia are listed below. See the left navigation bar to change the display.

Pre-Test Probability (Prevalence): %. Post-Test Probability (Predictive Value): %. Switch to display mode.
**Note that calculating probabilities from more than one finding is inherently inaccurate because findings are not independent. (For example, using two positive findings that share a common pathogenesis is likely to overestimate the true probability.)
Sensitive and Specific Findings
FindingResult SensitivitySpecificity
[ + ] Neutrophil Hypersegmentation + 0 - 90%97%
[ + ] Serum B12 + 0 - 100%95%
Specific Findings
FindingResult SensitivitySpecificity
[ + ] Increased MCV + 0 - 16%99%
[ + ] High LDH + 0 - 22%98%
[ + ] Either Low Serum B12 or Low Serum Folate + 0 - 84%92%
Sensitive Findings
FindingResult SensitivitySpecificity
[ + ] Macroovalocytes + 0 - 100%82%
[ + ] Anisocytosis + 0 - 90%59%
[ + ] Elevated Serum Methylmalonic Acid or Homocysteine + 0 - 89%73%
Poorly Diagnostic Findings
FindingResult SensitivitySpecificity
[ + ] Increased MCV + 0 - 74%75%
[ + ] RDW, increased + 0 - 75%33%