A patient with vitamin B12 deficiency may anisocytosis in various white blood cell lineages. The authors are from SampurnaSodani Diagnostic Clinic and GM Medical College in Indore, India.
Patient selection: subclinical vitamin B12 deficiency (normal or near normal hemoglobin, no macrocytosis; low serum vitamin B12 concentration).
Analysis: Beckman Coulter LH 750 or other analyzers reporting white blood cell anisocytosis using VCS (volume conductivity scatter)
WBC Lineage
Designation
Upper Limit of Normal
monocyte
MoV-DW
8.71
neutrophil
NeV-DW
6.89
lymphocyte
LyV-DW
5.86
where:
• V-DW indicates volume distribution width.
• The units for V-DW are not given.
Interpretation:
• If the patient's white cell lineage shows anisocytosis (V-DW above upper limit of normal), then vitamin B12 deficiency may be present.
• In the study cohort with vitamin D deficiency, anisocytosis in monocytes was seen in 86%, in neutrophils 80% and in lymphocytes 56%.
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