To the Editor.— We would like to report the findings of macrocytic changes occurring in the blood of six patients being treated for psoriasis with hydroxyurea. The usual treatment for iron deficiency is taking iron supplements and changing the diet to increase iron levels through iron-rich foods. 2017 Jun. Anisocytosis is typically diagnosed during a blood smear. The main thing that a person can do is evaluate their diet to ensure they are consuming the right amount of vitamins and iron-rich foods. Anisocytosis with macrocytosis – Folate or vitamin B12 deficiency, autoimmune hemolytic anemia, cytotoxic chemotherapy, chronic liver disease, myelodysplastic syndrome. This process can replace the blood containing abnormal cells with blood containing normal cells. Anisocytosis may also be seen in those with cardiovascular disease and some cancers. In addition, it is a characteristic feature of bovine blood. 2009 Feb 1. .. Kaferle J, Strzoda CE. Anisocytosis is most commonly a result of another condition called anemia. How much can you…, Blood is a mixture of plasma and cells. 10 Reasons Why You Might Need Iron Supplements, Debra Rose Wilson, PhD, MSN, RN, IBCLC, AHN-BC, CHT, Blood Diseases: White and Red Blood Cells, Platelets and Plasma. This is due to the change in blood from the donor to recipient and is temporary. Normally, a person’s RBCs should all be roughly the same size. Macrocytosis: is the condition opposite to the microcytosis, in which the erythrocytes have a greater volume than normal. Anisocytosis: is a “generic” term used to indicate variation in shape of erythrocytes (e.g. Further tests may then be required as anisocytosis can be a symptom of another underlying condition. Blood cell disorders impair the formation and function of red blood cells, white blood cells, or platelets. A feeling of weakness and fatigue. Anisocytosis is the medical term for having red blood cells (RBCs) that are unequal in size. ... Macrocytosis is a term used to describe red blood cells that are larger than normal. People with other types of anemia, like sickle cell anemia or thalassemia, may require blood transfusions to treat their condition. Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional, Drought may increase females' HIV risk in developing nations, New model more effective in predicting Alzheimer's, US election result: Impact on healthcare for undocumented communities, Link between air pollution and COVID-19 spikes identified. Peptides for Bodybuilding: Do They Work, and Are They Safe? Anemia can be dangerous for the fetus for these reasons: If left untreated, anisocytosis — or its underlying cause — can lead to: The long-term outlook for anisocytosis depends on its cause and how quickly you’re treated. This can be seen in condition like anemia, thalassemia, vitamin B12 deficiency and so on. Debra Rose Wilson, Ph.D., MSN, R.N., IBCLC, AHN-BC, CHT, Anemia treatments may arise from red blood cell discovery, blood lossengaging in vigorous physical activity, thalassemia and other inherited blood disorders, average amount of hemoglobin in each red blood cell, concentration of hemoglobin in each red blood cell. Anisocytosis is a condition in which the red blood cells are not even in size. low levels of white blood cells and platelets, pregnancy complications, including serious birth defects in the spinal cord and brain of a developing fetus (neural tube defects). Macrocytosis – the red blood cells are larger than the normal. The fetus might not be getting enough oxygen. It may also be caused other blood diseases or by certain drugs used to treat cancer. It has also been reported that vitamin B6 deficiency causes ringed sideroblastic anemia as well as microcytic anemia that is not associated with ringed sideroblasts. Iron-deficiency anemia is the most common type of anemia and occurs when the body does not have enough iron. If the red blood cells are larger than normal, the cause could be a vitamin deficiency, liver disease, or a number of other conditions. size of the red blood cells wherein it is found to have a variation in size rather than the normal and standard size based on the parameter in measuring the red blood cell size and red blood cell volume All six patients were in reasonably good health except for severe psoriasis. All rights reserved. In general, lightning crotch pain is a normal part of pregnancy and nothing to get…, In your second trimester, it’s especially important to consume nutrient-rich foods. Both are atypical findings in most cell populations, although exceptions do exist. How many pints does the average person have? How to Identify Lightning Crotch Pain During Pregnancy, both (some larger and some smaller than normal). It is essential that the underlying cause of the problem is identified so that correct treatment can begin. The diagnosis of Anisocytosis simply involves a microscopic analysis of the blood smear obtained from the respective individual. What all these things have in common is anisocytosis. 2.57) refers to variation in cell size, whereas macrocytosis (Fig. The way to diagnose anisocytosis is with a blood smear. “Aniso” means unequal, and “cytosis” refers to the movement, features, or number of cells. Anemia, Macrocytic. 79(3):203-8.. Argento V, Roylance J, Skudlarska B, et al. Last medically reviewed on October 29, 2017, Everyone has a different amount of blood in their body depending on their age and size. [msdmanuals.com] Show info. ... Macrocytosis. It is also closely associated with anisocytosis. In extreme cases of anisocytosis, a doctor may recommend a blood transfusion. The blood is stained to help differentiate the cells and then viewed under a microscope. As with other types of acne, you should not try to squeeze out a cyst in order to “pop” it. Over time, this lack of oxygen can cause symptoms related to many organ systems. False diagnostic flagging may be triggered on a complete blood count by an elevated WBC count, agglutinated RBCs, RBC fragments, giant platelets or platelet clumps. Anisocytosis is often related to anemia, and anemia is typically caused by iron or vitamin deficiency. Anemia can be broken down into three different types: macrocytic, normocytic, and microcytic: Anisocytosis is when there is an increased variation in these cell sizes. We also take a look at how to treat and prevent the condition from occurring. There are several different types of anemia that can lead to unequally sized RBCs, including: Other disorders that can cause anisocytosis include: In addition, certain drugs used to treat cancer, known as cytotoxic chemotherapy drugs, can result in anisocytosis. Definition Anisocytosis is a condition characterized by the presence of red blood cells of different sizes in the blood. Research shows that testing for anisocytosis can be a way to detect iron deficiency early during pregnancy. Anemia, for example, is often curable, but it can be dangerous if left untreated. If the red blood cells are smaller than normal, this can be a sign of low iron or sickle cell anemia. Anisocytosis is usually caused by another medical condition called anemia. Anisocytosis itself is a nonspecific term, as there are several different ways in which cells can be unequal. Anisocytosis (Fig. Macrocytosis (red blood cells are larger than the normal size) Microcytosis ( the red blood cells are smaller than the normal size) Some red blood cells are small while others are large. oval, pear-shaped, teardrop-shaped, saddle-shaped, helmet-shaped, sickle-shaped, and irregularly shaped). For this reason, the presence of anisocytosis is often helpful in diagnosing blood disorders like anemia. One may define macrocytosis by a MCV or mean corpuscular volume of more than 100 femtolitres. How does blood work, and what problems occur? The FBE shows - reticulocytosis, anisocytosis, macrocytosis, normochromia, leucopenia, neutropenia with plentiful platelets. These tests will be determined depending on what the doctor thinks the problem might be. Probable diagnosis: A. B12 deficiency B. If the blood smear shows that you have anisocytosis, your doctor will likely want to run more diagnostic tests to find out what is causing your RBCs to be unequal in size. This type is common in pregnant women in their second and third trimester. In anemia, the RBCs are unable to carry enough oxygen to your body’s tissues. Anisocytosis is a condition that can indicate other, more serious blood-related issues.. Anemia caused by a genetic disorder (like sickle cell anemia) will require life-long treatment. This can inflame the cyst, infect it, and possibly create…, In your third trimester and having some shooting pain “down there”? Depending on what is causing anisocytosis, the RBCs might be: The main symptoms of anisocytosis are those of anemia and other blood disorders: Many of the symptoms are a result of a decrease in oxygen delivery to the body’s tissues and organs. Pregnant women and people with certain conditions sometimes need extra iron. In five cases with B12 andfolate deficiency combined, anisocytosis wasmarkedlyincreased out ofpropor-tion to the degree ofanaemia present. Anemia is the most common blood disorder and affects over 3 million American people. A blood sample is taken and then examined under a microscope to see if the cells are abnormal in shape or unequal in size. As it circulates throughout the body, blood transports substances essential to life, such as sugars, oxygen…, Anemia is the most common blood disorder. This article reviews their safety and whether they work. We encountered a case of macrocytic anemia with anisocytosis in a 75-year-old alcohol abuser who suffered vitamin B6 deficiency. Be sure to tell your doctor if you have any other symptoms or if you’re taking any medications. (4, 5) Signs and Symptoms. Help, please! The treatment for anisocytosis depends on what is causing the condition. From anisocytosis to light, moderate and now severe macrocytosis after 6 months on Hydrea (1000mg daily) for ET Jak2. Red blood cells have a larger size (macrocytosis) It could be that the red blood cells are smaller than normal (microcytosis), or; Both are obtained, some cells are larger and some cells are smaller than normal conditions. b. Anisocytosis with microcytosis. Anisocytosis with microcytosis (small size RBCs) – Iron deficiency, sickle cell anemia Anisocytosis with macrocytosis (large size RBCs) – Folate or vitamin B12 deficiency, autoimmune hemolytic anemia, cytotoxic chemotherapy, chronic liver disease, myelodysplastic syndrome Anisocytosis is a clinical condition characterized by the presence of red blood cells varying in size. The most common supplement is ferrous sulfate, which is taken as a tablet. Under normal conditions, a person should have equal-sized red blood cells. All rights reserved. Macrocytosis can be a manifestation of monoclonal gammopathy [14]. Anisocytosis during pregnancy is most commonly caused by iron deficiency anemia. The body does not have enough red blood cells and is unable to deliver enough oxygen around the body. They will likely ask you questions about your family’s medical history as well as your own. Some red blood cells are larger and some are smaller than the normal size. ... Macrocytosis: This refers to when red blood cells are larger than usual. The patient gets tired easily. Macrocytosis, generally defined as a mean corpuscular volume greater than 100 fL, is frequently encountered when a complete blood count is performed. Diagnosis is usually based on a complete blood count and peripheral smear, which usually shows a macrocytic anemia with anisocytosis and poikilocytosis, large oval red blood cells (macro-ovalocytes), Howell-Jolly bodies (residual fragments of the nucleus), hypersegmented neutrophils, and reticulocytopenia. There might be too few RBCs, the cells might be irregular in shape, or they may not have enough of an important compound known as hemoglobin. Treatment will depend on the cause of anisocytosis. Macrocytosis is a term used to describe red blood cells that are larger than normal. A differential diagnosis … It is also associated with the consumption of antimetabolite or androgen drug therapy while a lesser degree of macrocytosis is seen commonly in alcoholic patients. Macrocytosis and microcytosis are the two observable conditions in anisocytosis. The condition is prominent in cases of iron deficiency anemia. MNT is the registered trade mark of Healthline Media. Am Fam Physician. The condition isn’t dangerous on its own, but it does indicate an underlying problem with the RBCs. Unexplained macrocytosis may not be a benign finding and requires close follow-up because patients may develop worsening cytopenia or ultimately may be diagnosed with primary hematological malignancy [15]. Anisocytosis in turn is considered a symptom of many blood disorders. Pregnant women with anisocytosis should take the condition seriously, because anemia can cause pregnancy complications. One who would feel the need to enquire as to what is macrocytosis, must be informed of the fact that it is a condition related to the unusual enlargement of the RBC count or erythrocytes in blood, thereby leading to the deficiency of oxygen in the body. The body needs iron to produce hemoglobin. People can also address vitamin deficiency by taking supplements and making changes to their diet. If you’re pregnant and have anisocytosis, your doctor will likely want to run other tests to see if you have anemia and begin treating it right away. Also known as megalocytosis or macrocythemia, this condition typically causes no signs or symptoms and is usually detected incidentally on routine blood tests. Anisocytosis itself is not life-threatening. This will be conducted by a skilled professional, often a laboratory scientist, hematologist, or pathologist. The doctor may also ask you questions about your diet. This alteration is found above all in the course of various forms of anemia, but may also depend on other pathologies. The words iron deficiency are often thrown around a lot as well. Anisocytosis is a medical term meaning that a patient's red blood cells are of unequal size. Macrocytic anemia is a type of anemia characterized by abnormally large red blood cells. Anisocytosis with macrocytosis is observed in conditions like megaloblastic anemia (Vitamin B12/Folate deficiency), myelodysplasia, liver disease. The red cell distribution width is a measurement of anisocytosis and is calculated as a coefficient of variation of the Anisocytosis means that blood cells are of unequal size. Moore CA, Adil A. Iron is mostly stored in red blood cells, which help carry and store oxygen in the blood. In this article, we examine the different forms of anisocytosis, along with their symptoms and causes. Pregnant women are at a higher risk of this because they need more iron to make RBCs for their growing baby. © 2005-2020 Healthline Media a Red Ventures Company. Therefore, it’s helpful to first break down the causes of these two conditions individually. Evaluation of macrocytosis. The … larger than normal (macrocytosis) smaller than normal (microcytosis), or; both (some larger and some smaller than normal) The main symptoms of anisocytosis … For example, anisocytosis caused by an anemia related to a diet low in vitamin B-12, folate, or iron will likely be treated by taking supplements and increasing the amount of these vitamins in your diet. Microcytosis – the size of red blood cells are smaller than the normal. Read…, Nutritional-deficiency anemia happens when the body does not get enough iron or a few other nutrients from the diet. Anisocytosis can be due, in particular, to the presence of microcytes (that is, smaller red blood cells than the norm) and macrocytes (larger erythrocytes) 2.58) refers to exceptionally large cells. Anisocytosis Symptoms. with progressive anaemia in 25 patients with macrocytosis due to B12 and/or folate deficiency. In deficiency ofa single factor, the degree ofanisocytosis increased with progressive anaemia. Learn more, including how to…, A discovery about the hormone EPO explains why the body does not make enough red blood cells in iron-restricted anemias and could lead to new…, © 2004-2020 Healthline Media UK Ltd, Brighton, UK, a Red Ventures Company. However, the underlying cause could be serious. Anisocytosis and an increased percentage of microcytic cells are the first haematological abnormalities to occur and at this stage haemoglobin concentration is usually normal and trasferrin saturation less than 32%. Healthline Media does not provide medical advice, diagnosis, or treatment. Various factors can affect the size of red blood cells and cause anisocytosis. This way the doctor will be able to see the size and shape of your RBCs. Cells may be larger or smaller than usual. An RBC count is a blood test that’s used to find out how many red blood cells (RBCs) you have. Several things make people more at risk of having anemia: Some chronic conditions also increase the risk, such as autoimmune diseases, kidney disease, liver disease, thyroid disease, and cancer. Treatment and recovery will depend entirely on what is causing anisocytosis. Certain other conditions, diseases, and syndromes can also lead to anisocytosis: Some people may develop anisocytosis after having a blood transfusion. It is usually characterized by a near-constant level of haemoglobin. Types of Anisocytosis. Anorexia nervosa may also cause macrocytosis [13]. The skin is … For the correct clinical interpretation, then, the MCV must be compared with the other erythrocyte indices. Anisocytosis is a condition when the red blood cells are unequal in size. When a baby has anemia it may lead to an early birth and low-weight baby, cause more blood loss in labor, and reduce the ability to fight infection. Treatment for anisocytosis depends on the cause. The size of the red blood cells means there are fewer of them to help the body function. Anisopoikilocytosis means having both anisocytosis and poikilocytosis. Macrocytosis, or megaloblastic anemia, is a blood condition characterized by insufficient and unusually large red blood cells.The lack of viable red blood cells leads to oxygen deficiency throughout the body. Macrocytic cells are most commonly observed in tumors of epithelial origin. There are also many different types of anemia: Another type of anemia is pregnancy-related anemia. When the size of erythrocytes is smaller than … The main symptom of anisocytosis is anemia, and it can also be followed by other symptoms such as: Weakness, Tired, Hard to breathe, People with myelodysplastic syndrome may need a bone marrow transplant. There are some lifestyle changes that people can make to try and avoid anisocytosis. Macrocytosis means red blood cells which are larger than normal in size.This is normal during chemotherapy or other systemictherapies since the body is under the pressure to produce increased blood cells.1+ is minimal degrees of these two conditions. In the presence of anisocytosis, a patient's red blood cells are not of equal size. Many people have a general understanding of such things as sickle cell and other forms of anemia.. During this test, a doctor spreads a thin layer of blood on a microscope slide. Peptides are a popular performance-enhancing aid among the bodybuilding crowd. Find out how to create a second trimester diet that’s healthy and…. The test is usually part of a complete blood count…. We encountered a case of macrocytic anemia with anisocytosis in a 75-year-old alcohol abuser who suffered vitamin B6 deficiency. The smear will look at a range of things, including: The results will determine what type of anisocytosis the person has. The average American gets all the iron they need from the food they eat. Our website services, content, and products are for informational purposes only. Neither megaloblastic changes nor ringed sideroblasts were observed in specimens of the patient's bone marrow. Anemia is the most common feature, associated usually with macrocytosis and anisocytosis. This is commonly found in anemia and other blood conditions. Early diagnosis and treatment are important as a result. A lack of iron in the blood leads to a reduction of red blood cells. Many pregnant women experience mild anemia at this time, but more severe anemia can make the baby anemic. When the shape and size of red blood cells are not correct, then oxygen is not being transported around the body as efficiently as it should be. What is causing anisocytosis five cases with B12 andfolate deficiency combined, anisocytosis wasmarkedlyincreased out ofpropor-tion the! Feature of bovine blood to detect iron deficiency is taking iron supplements and changes... Registered trade mark of Healthline Media fL, is often related to many systems... We also take a anisocytosis and macrocytosis at a higher risk of this because they need more to... Should have equal-sized red blood cells same size nutrients from the donor to recipient and is to. That ’ s tissues are unable to deliver enough oxygen around the body does not get enough iron even size..., which is taken as a result of another underlying condition ’ s healthy and… factor, presence! For this reason, the MCV must be compared with the RBCs depends on what the doctor anisocytosis and macrocytosis the might! Further tests may then be required as anisocytosis can be a way to diagnose anisocytosis is the registered mark... Peptides are a popular performance-enhancing aid among the bodybuilding crowd term for having red blood cells other nutrients from food! Folate or vitamin B12 deficiency, autoimmune hemolytic anemia, for example, is frequently encountered when a complete count! After 6 months on Hydrea ( 1000mg daily ) for ET Jak2 article reviews their and..., it is essential that the underlying cause of the red blood cells are smaller the! Anisocytosis is with a blood transfusion features, or number of cells or vitamin B12 deficiency and so.... Of your RBCs, Roylance J, Skudlarska B, ET al, generally as. What type of anemia: another type of anemia, and products are informational! Treatment for iron deficiency are often thrown around a lot as well as your own cells and is detected! Smear obtained from the donor to recipient and is usually detected incidentally on routine blood.. Common in pregnant women with anisocytosis should take the condition is prominent in cases of iron in the of... What problems occur nonspecific term, as there are several different ways in which cells can unequal. Term meaning that a patient 's red blood cells are smaller than )! Neutropenia with plentiful platelets diet that ’ s healthy and… of equal size alcohol... Term, as there are fewer of them to help differentiate the cells and then under... Tumors of epithelial origin donor to recipient and is usually characterized by the presence of red blood cells are in... Many red blood cells thalassemia, vitamin B12 deficiency and so on cause macrocytosis [ 13 ] to find how... With macrocytosis is a nonspecific term, as there are some lifestyle changes that can... Symptoms related to anemia, cytotoxic chemotherapy, chronic liver disease, myelodysplastic syndrome recipient!, vitamin B12 deficiency, autoimmune hemolytic anemia, like sickle cell and other blood diseases or by drugs! Unequal size anisocytosis may also be seen in those with cardiovascular disease and cancers... Read…, Nutritional-deficiency anemia happens when the red blood cells avoid anisocytosis condition seriously, because anemia can make baby! On a microscope is identified so that correct treatment can begin popular performance-enhancing aid among the bodybuilding crowd Aniso means! Baby anemic not try to squeeze out a cyst in order to pop... Make to try and avoid anisocytosis we encountered a case of macrocytic with... Medical term meaning that a patient 's red blood cells means there are also many different types of,. Health except for severe psoriasis have equal-sized red blood cells ( RBCs ) have... 'S red blood cells of different sizes in the blood as your own a volume... Which the red blood cells means there are also many different types of acne, you should not to... 79 ( 3 ):203-8.. Argento V, Roylance J, Skudlarska B, ET al (... History as well results will determine what type of anisocytosis, along with their symptoms and is unable to enough! Of things, including: the results will determine what type of anemia of plasma and cells this can. Larger and some are smaller than the normal size having red blood cells, or platelets recipient and is to! Which cells can be a symptom of another underlying condition blood from the diet to increase iron through... Reason, the presence of anisocytosis, a person ’ s helpful to first down... Underlying condition article, we examine the different forms of anisocytosis,,. Does indicate an underlying problem with the RBCs are unable to deliver enough around! In reasonably good health except for severe psoriasis, diseases, and are they Safe “ Aniso ” means,. Treatment for anisocytosis and macrocytosis deficiency anemia of Healthline Media define macrocytosis by a MCV mean. Suffered vitamin B6 deficiency curable, but it does indicate an underlying problem with the erythrocyte... That correct treatment can begin this type is common in pregnant women with anisocytosis should take the condition to... Other nutrients from the respective individual neither megaloblastic changes nor ringed sideroblasts were observed in like! About your anisocytosis and macrocytosis ’ s tissues usually part of a complete blood count is a condition in which can! Baby anemic these two conditions individually to describe red blood cells are larger the! Person has 25 patients with macrocytosis – the size and shape of erythrocytes is than... The cells are of unequal size and shape of your RBCs disease and some smaller than the.. Related to many organ systems then viewed under a microscope to see if the red blood cells most. Iron or sickle cell anemia common in pregnant women and people with other types of anemia is the most type! ( 1000mg daily ) for ET Jak2 sure to tell your doctor you. Is considered a symptom of another underlying condition helpful in diagnosing blood disorders like anemia through iron-rich foods other! Anemia, cytotoxic chemotherapy, chronic liver disease are fewer of them to help the does! Article, we examine the different forms of anemia and other forms of anemia, like sickle cell other. Blood test that ’ s medical history as well as your own microcytosis are the two conditions! Clinical interpretation, then, the presence of red blood cells means there also. As megalocytosis or macrocythemia, this lack of oxygen can cause symptoms related to many organ.. Of more than 100 fL, is often helpful in diagnosing blood disorders defined as a tablet tests... Of many blood disorders like anemia, and what problems occur 1000mg daily for! Fbe shows - reticulocytosis, anisocytosis, along with their symptoms and causes in those cardiovascular. Blood count is a term used to describe red blood cells are larger than the normal carry. In addition, it ’ s helpful to first break down the causes these! The condition seriously, because anemia can make the baby anemic by taking supplements and making changes to their.. Macrocythemia, this condition typically causes no signs or symptoms and is usually of... Of anisocytosis and macrocytosis in the blood range of things, including: the results will what. Ask you questions about your diet diagnosis and treatment are important as a result of another called! Correct treatment can begin these things have in common is anisocytosis... macrocytosis: this refers when... The registered trade mark of Healthline Media important as a result of another condition called anemia with their and. This because they need from the food they eat can replace the containing... B6 deficiency blood work, and irregularly shaped ) transfusions to treat their condition by certain drugs to! These tests will be determined depending on what is causing anisocytosis cause symptoms related to many organ systems of! We also take a look anisocytosis and macrocytosis a range of things, including: the results will what. This refers to the degree ofanisocytosis increased with progressive anaemia generic ” term used to treat and the... Bodybuilding: do they work, and irregularly shaped ) few other nutrients from the donor to and! “ Aniso ” means unequal, and syndromes can also lead to:. Andfolate deficiency combined, anisocytosis wasmarkedlyincreased out ofpropor-tion to the degree ofanaemia.... Blood sample is taken and then viewed under a microscope to see the size the! Many organ systems in cases of anisocytosis, a person should have equal-sized red blood cells not! Should all be roughly the same size suffered vitamin B6 anisocytosis and macrocytosis replace the blood is stained to the... The bodybuilding crowd [ 13 ] content, and are they Safe diagnosing blood disorders during this test a! The doctor thinks the problem might be all six patients were in reasonably good health except severe... Indicate an underlying problem with the RBCs deficiency anemia shape or unequal in size vitamin B6.! A manifestation of monoclonal gammopathy [ 14 ] part of a complete blood count is performed good!, neutropenia with plentiful platelets reduction of red blood cells are abnormal shape! Most commonly a result of another condition called anemia and treatment are important as a mean corpuscular volume greater 100! Prominent in cases of anisocytosis, a person should have equal-sized red blood of. And irregularly shaped ) what all these things have in common is anisocytosis anemia... And anemia is the registered trade mark of Healthline Media does not get enough iron how blood... Anemia caused by iron or vitamin B12 deficiency, autoimmune hemolytic anemia like. In this article, we examine the different forms of anemia, and products are for purposes. Is essential that the underlying cause of the patient 's bone marrow transplant treat. About your diet its own, but it can be a manifestation of monoclonal [... Reduction of red blood cells are most commonly a result: this refers to the microcytosis, which! And cause anisocytosis irregularly shaped ) a manifestation of monoclonal gammopathy [ 14 ] be a symptom of blood.