Megaloblastic anemia results from impaired DNA synthesis of the erythrocyte RBC precursors, resulting in:
1. Large immature red blood cells, called megaloblasts.
2. Small, pale red blood cells.
3. Juvenile red blood cells, called reticulocytes.
4. Elongated, hard, sticky, cells.
Large immature red blood cells, termed megaloblasts.
Rationale: Impaired DNA synthesis of the erythrocyte RBC precursors produce cells called megaloblasts. Due to their immaturity and large size, these cells are often sequestered in the bone marrow rather than released into the periphery. If released into the peripheral bloodstream, megaloblasts are subject to an increased rate of hemolysis due to structural defects in their membranes. Bone marrow sequestration and increased hemolysis result in a decreased total RBC count or anemia. Small, pale red blood cells are reflective of iron deficiency anemia. Reticulocytes are juvenile erythrocytes present in peripheral blood. Reticulocytes increase in most types of sustained anemia, as erythropoiesis accelerates as a compensatory mechanism. Their presence is not indicative of megaloblastic anemia. Elongated, hard, sticky, cells are found in sickle cell anemia.
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