Several tests can help to elucidate the underlying cause of a person's<unk> . A peripheral blood smear is often recommended as a first step in the evaluation to determine if the<unk>  has megaloblastic features since the causes of megaloblastic and non-megaloblastic<unk>  differ and making this distinction can narrow the list of differential diagnoses. For non-megaloblastic<unk> s, a reticulocyte count may be helpful. Non-megaloblastic<unk> s with a low reticulocyte count (indicating a poor bone marrow response to the anemia) suggest liver disease (e.g., cirrhosis), hypothyroidism, toxic effects of alcohol on the bone marrow, or myelodysplasia. In contrast, non-megaloblastic<unk> s associated with a high reticulocyte count (reticulocytosis) may be caused by hemolysis or bleeding. For megaloblastic<unk> s, useful tests may include serum levels of Vitamin B12, methylmalonic acid, and homocysteine. If there is no clear evidence of Vitamin B12 or folic acid deficiency, additional causes of megaloblastic anemia include copper deficiency, medications, and certain inborn errors of metabolism.
Macrocytic anemia
Lycopenemia
Plasmacytosis
Reticulocytosis
Neutrophilia
Microcytic anemia
Microhematuria
Hepatosplenomegaly